Opening the Market Days Times in Yorkshire

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					       Scott Road Medical Centre, Selby, North Yorkshire

                           Practice Profile, July 2008
Introduction

Scott Road is a single site practice with a list size approaching 10,500. However, it is
anticipated with the growth of population in Selby this will rise to 11,000 in the short term and
perhaps to as many as 15,000 in the next 5 years. We have a very young practice profile and
many patients who are socially disadvantaged - both factors resulting in relatively high patient
demand.

Practice History

The practice was established in October 1982, set up by Ian Lewis, the senior partner, in a
Portakabin on the ambulance station site in Flaxley Road. The list size has grown rapidly,
reflecting the growth in Selby’s population. Originally linked to the coalfields and the
associated power industry this is more recently attributable to the development of affordable
housing in an area with good road and rail links to Leeds, York and Hull. The practice moved
to its present, purpose built, accommodation in July 1985. 20 years later the building has had
some significant extensions which gives scope for the list size to increase to 11,000.

Historically, the practice has always been seen to be innovative and has played a full role in
fund-holding, the local Total Purchasing pilot and the formation of the Selby and District PCG.
The practice continues to be happy to be involved with the North Yorkshire and York PCT on
issues relating to the services in the local area as a whole rather than purely on a practice
basis and takes an active role in the local Practice Based Commissioning consortia. In
October 2001 we became a PMS pilot and have felt the flexibility offered by the PMS has
allowed us to improve services and access. We enjoy excellent relationships with the 2 other
practices in Selby.

Practice ‘Philosophy’ or how we work

We aim to provide a high standard of health care through an integrated team. In the last two
years we’ve achieved full QOF points. We have been paper light for many years and use the
iSOFT Synergy clinical system and Frontdesk appointments. All incoming mail is scanned and
distributed to doctors via Docman. Many letters from the local hospital trust are now sent very
quickly electronically. Most results are sent electronically. We use the Lexacom digital
dictation software so letters can be typed for you before you’ve finished surgery, when
needed! We have participated in last year’s IM&T DES to level three so all staff have had
basic computer training and all clinical notes are coded in a structured way. We have an
excellent, experienced administration team who help to support the IT and admin systems.
Our Deputy Manager is retiring in December so we are recruiting a new one currently.

Slightly unusually we are relatively keen advocates of Choose and Book and have found the
system usually works pretty well for us and our patients.

We have an extensive intranet, that crucially holds the rota and leave diary as well as lots of
clinical and admin information. You should visit our Internet site at www.scottroad.org.uk to
see more about us as individuals. Click on our photos to read more about us. We now offer
repeat prescriptions and online appointment booking for patients. We endeavour to turn
repeat prescriptions round in 24 hours, not the usual 48 hours. We also provide patients with a
telephone request line for repeat prescriptions, something many practices have stopped
doing. We have a pharmacy next to us where patients from where can choose to collect their
prescriptions.
We start surgery at 8.20am or 8.30am and at around 3.00pm. If we don’t have a formal
meeting we try to have an informal get together over lunch around 12 or 12.30 most days.

We hold fortnightly lunchtime education meetings with all clinical staff where problems of joint
interest are discussed. The doctors also have weekly lunchtime clinical meetings where, if one
of us isn’t presenting a specific topic we do random case analysis as a group. The day of the
week varies to ensure all part-times can attend some of the meetings. We’re able to have
lunchtime meetings because our visiting rate is relatively low. Quite often as a salaried doctor
you should have none or only one visit to do, though do be prepared for the exceptional day!

Advanced Access was introduced at Scott Road in June 2004. Early teething problems were
ironed out and patients are generally allocated a 10 minute appointments, this allows us to
see, on average 15 patients per session. We have recently signed up to a local enhanced
service offering GP appointments outside of our core hours. Currently we offer an early
morning, a late evening and a short Saturday surgery to patients who experience problems in
getting to see their GP during our core opening hours. We are investigating, as are the other
Selby practices whether to introduce the Stour Access System which involves GPs triaging all
requests for a GP appointment.

We try to adopt a ‘counselling approach’ to our patients, giving them time to express their
problems and ourselves time to offer appropriate advice. Emphasis is placed on preventative
care and teaching of self care of minor ailments. Our vision for the coming years is to
continue to offer the best service possible to our patients and to develop appropriate services
in relation to local needs.

The Practice Team

We currently have 4 full time (1 of which is job shared) and 2 part-time partners. In addition
we employ 3 part-time salaried GPs and a regular locum. Our vacancy arises as one of our
salaried doctors is leaving to work abroad. Scott Road is a training practice for the Hull and
York Medical School and we are an approved training practice. In the last few years we have
trained Foundation Year two doctors. We hope to have a GP registrar in August 2009. All the
doctors provide clinical responsibility for the F2 doctors with time blocked out of surgery to
enable this.

Dr Shaun O’Connell is the Executive Partner, a member of North Yorkshire’s Local Medical
Committee, a GP trainer and a GP Appraiser. Dr Renny Lord has an interest in Occupational
Medicine and looks after our patients on methadone prescriptions. Drs Paul Docherty and
Mary Clatworthy are responsible for the HYMS 3 students and have been assisted by Dr Ruth
Walker. Drs Renny Lord and Richard Wilcox teach HYMS 5 students. Dr Kath Hodkin is a
member of the Selby Practice Based Commissioning Board. Dr Ian Lewis, who established
the practice is going to reduce his commitment in October 2008 to six sessions per week as
he moves towards retirement.

Further details about us and the nursing team are on our website. We have an excellent,
extensive nursing team with one Nurse Practitioner, one Minor Illness Nurse Prescriber, three
Practice Nurses and a Health Care Assistant. This skill mix really helps us deliver services to
our patient population. Recently the senior nurses have started to be fully responsible for the
management of hypertension. Our Health Care Assistant is adept at ‘working patients up’ who
have suspected high blood pressure to help GPs decide on further management. She is also
skilled in smoking cessation advice and spirometry.

All phlebotomy is done at the local ‘cottage’ hospital or at an Asda superstore in York! At
Selby War Memorial Hospital there are some in patient beds where we sometimes look after
patients (usually as a stepping stone from the acute trust to home or residential care or for
elderly respite and terminal care). There is also a minor injuries unit that tries to be open 24/7.
We do our minor surgery here once a week. The out of hours service is also run from here
and two of our doctors still do out of hours sessions. Some patients are seen in the outpatient
department here by visiting consultants from York. There are also Physiotherapy and X-ray
facilities here.

Other clinicians based at the practice

We have a very effective Primary Health Care Team with attached staff housed on site. This
has operated as a self managed team over the past 6 years. The team are involved in much
of the decision making at he practice and the culture is very much one of involvement for both
clinical and administrative staff. In addition to the Primary Health Care Team we offer an in-
house counselling service and also allow the premises to be used weekly by the PCT
psychology service, the Primary Care Mental Health worker and the Drugs Liaison Nurse. A
private physiotherapist also uses our rooms to see patients twice a week.

Practice Decisions

We have regular partnership meetings with an agenda and minutes that are copied to salaried
doctors. All important items are discussed and decided upon entirely democratically. Practice
decisions are normally agreed unanimously but occasionally things have to be agreed by
majority voting. The Executive Partner implements practice meeting decisions and deals with
the day to day administrative matters.

Sabbaticals

After 5 years with the practice then every 5 years partners can take up to 6 weeks off,
extended to 8 by the addition of 2 weeks’ annual leave. Sabbaticals are funded by the
practice.

Additional responsibility

All the Salaried GPs have the option of having areas of clinical responsibility (eg a QOF
domain, or a LES) and of running the timetabling of clinical or education meetings. Some
surgery is allocated to these achieving these tasks.

Selby itself

Selby is a diverse area. It is a predominantly rural district of North Yorkshire, situated south of
York and east of Leeds with 3 main settlements – Selby town itself, Tadcaster and Sherburn in
Elmet. It has a total population of 76,500. The North Yorkshire Moors are a 45 minute drive
and the Dales and the coast are within easy reach. The town itself stands on the River Ouse,
the focal point being the impressive Abbey dating back to the 11th century. Despite recent
developments in the area Selby retains a small town atmosphere with a weekly market and a
monthly farmers’ market. Agriculture remains the traditional commercial activity. As well as
being an inland port main employers include a flour mill, an animal foodstuff manufacturer and
a small chemical works. Retail and industrial parks are rapidly developing within the district.
There are plans for a large growth in housing in Selby itself and in the wider community.

There are good primary schools and the local comprehensive schools and tertiary college
have a good reputation. Private education is available locally and in York and Leeds.

In general the district is relatively affluent with a higher than average rate of employment
(83%). The area is well served by major roads and there is a direct train service to London as
well as access to the East Coast main line at York, Leeds and Doncaster.

				
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