Practice
Our practice philosophy is to provide high quality medical care in a friendly patient-centred and compassionate manner.
The Practice
The Caythorpe and Ancaster medical practice is a semi-rural, training and teaching practice working from two sites, providing health care for a population of 8300 patients. We work under a Personal Medical Services (PMS) contract and dispense medication to the majority of our patients.
We aim to be innovative by incorporating the best of the new whilst not losing sight of the importance of the traditions of good family medicine. We embrace current evidence based medical thinking and try and apply this to the care of our patients.
Our policy has always been to embrace healthcare reforms, but to interpret them in a way that we feel is meaningful and enhances the care of our patients. Thus, for example, we were one of the original Primary Care Act Pilot sites nationally, and used this initiative to develop chronic disease management within the practice. More recently we have been able to adopt the principles of the nGMS contract into our working practice and have, with minimal additional workload, been able to achieve very high Quality and Outcome Framework (QOF) points and we would seek to maintain this level of achievement – not merely as a matter of data collection, but rather as an index of high quality co-ordinated clinical care which is in the best interest of our patients.
There are well-developed systems for chronic disease management within the practice and this aspect of care now forms the large majority of our work (75%+). Consultations for minor illness are relatively uncommon and we believe that this is due to the consistency of approach by the doctors in the practice with regard to patient education and limited prescribing for minor illness, together with good support from our attached Health Visitor.
The practice has a long standing involvement with, and commitment to, GP registrar and health care professional training.
The practice uses the EMIS computer system for medical records and is paper-light. There is an IT link between both sides of the practice. Consultations are exclusively recorded in an electronic format. Paper records are used only to access hospital correspondence. We take great care and pride in high quality record keeping and aim to maintain accurate clinical data and patient summaries, organised in a very structured format, on our clinical I.T. system. Not only does this enhance good clinical care and audit but also, in the past, it has enabled us to contribute to regional and national research studies.
The Locality
The practice is situated in South West Lincolnshire, east of the Nottingham/Lincolnshire border, between Grantham and Sleaford. The nearest cities are Lincoln (18 miles), Nottingham (35miles), and Leicester (40 miles). Road access to the north and south is excellent with the A1 nearby, and London is just over an hour away on the main east coast railway line. Both villages are well served with excellent primary schools and the community benefits from a highly regarded secondary school system. The surrounding countryside is attractively undulating and wooded - very different from the flat landscapes to the east more commonly associated with the Lincolnshire fens.
We cover a fairly scattered low-density rural population spread over approximately forty small villages. The surgeries are based in Caythorpe and Ancaster, the two largest of these villages, which are approximately 6 miles apart, covering some 40 other villages.
Patients & Surgeries
The practice population broadly reflects national demographics but with rather less young adults and slightly more elderly than average. The vast majority of patients attend the surgery, but a number of home visits, on average between one and two per doctor, are done daily. Typically these are for those patients who are elderly/housebound or who are terminally ill.
The population is split evenly between these sites and so both surgeries provide a full compliment of services supported by appropriate staff. The surgery premises at Caythorpe have been extended to provide designated consulting rooms for all the doctors and GP registrar based there. A new purpose-built surgery was opened in Ancaster in December 2006 and provides a state of the art facility for patients in this area.
Two of the partners are based at Caythorpe (Drs Watts and Robinson) and two at Ancaster (Drs Zbrzezniak and Gilmore) with a salaried doctor working across both sides of the practice – although there is cross cover to provide flexibility for holiday/study leave. We believe that this system gives the right combination of continuity of care, while retaining flexibility that our patients appear to value.
As a practice we are justifiably proud to have achieved maximum QOF points in 2004/5 and 2005/6 and near maximum in 2006/07. We are committed to on-going staff development to ensure we maintain the highest level of service to our patient population.
The Team
The practice team, both administrative and clinical, with whom we work, share our sense of commitment to their work and we function, as an organisation, in a very egalitarian way. We greatly value our staff and work very closely together with them, as a team, in all aspects of our work. The staff, both employed and attached, are very loyal and committed to the practice and our patients. We are privileged in having a high retention rate /low turnover rate of staff.
We are fortunate to have an excellent practice nursing team, together with health care support workers, who work across both sites of the practice. They are involved in much of the chronic disease management within the practice, together with more traditional nursing duties. Each practice nurse has an area of specialist skill/expertise. The practice nurse work under the management of a nurse team leader who, as well as managing the team and providing core practice nursing care, has an interest in contraception and a high level of expertise in providing long acting reversible contraception - both IUS/IUD and Implanon.
We have a team of attached District Nurses and an attached Health Visitor and we greatly value the close links and good communication that we have with them. There is a lot of informal day-to-day communication with the attached team but we also have regular team meetings too.
The PCT
The practice works within the NHS Lincolnshire Primary care Trust (PCT). This organisation is responsible for improving the health of the local population by working in Partnership with local health and social care organisations.
Out of Hours work for the practice is covered by the local PCT from Grantham Hospital.
Teaching & Training
The practice has a long history of involvement with GP registrar training within the local Lincoln Vocational Training scheme. Two of the four partners (Drs Watts and Robinson) are approved GP trainers and Dr Monaghan hopes to be approved as GP trainer in the very near future.
All of the doctors are actively involved with GP registrar training. At any one point in time the practice typically has two GP registrars.
The Partners
We feel highly privileged that, despite the rapidly changing nature of primary care and heath care reforms, we thoroughly enjoy and are professionally fulfilled by our work. We are firmly committed to helping our patients and developing primary care services for them. We set ourselves high standards of clinical care and believe in the pursuit of excellence, yet feel that being supportive and compassionate to our patients is equally important. The environment in which we work is very relaxed and informal as we work in partnership with our staff in helping our patients. We believe in the importance of ongoing professional development and structure our working timetable to accommodate protected time for this. We believe that we can only work to our best ability if we maintain a healthy professional/personal life balance and therefore acknowledge the importance of working in a family friendly way, while balancing this against service commitments.
We believe in the importance of delegation of non-clinical work so that we can best utilise our clinical expertise and so rely heavily on our attached nursing and administrative staff together with our Practice Manager.