Moving to a Darzi centre pays off

Posted on October 22, 2009. Filed under: GP-led health centres, News stories, Providers | Tags: |

Healthcare Republic | GP Newspaper | 22 October 2009

Taking a salaried job at a new GP-led health centre has revitalised my career, says Dr Sally Johnson.

Dr Sally Johnson has clinical responsibility for the GPs and nurses working at Ashford Health Centre

Dr Sally Johnson has clinical responsibility for the GPs and nurses working at Ashford Health Centre

Earlier this year I left the perceived safety of traditional general practice and became GP lead at a Darzi centre in Ashford, Surrey that also houses an NHS walk-in centre and a new GP surgery. Independent company Greenbrook Healthcare runs the centre.

Despite initial misgivings, I believe that this career leap is one of the best decisions I have ever made.

After qualifying in 1993 I spent five years in paediatrics but switched to general practice after my first child’s birth. I had two more children and opted for part-time salaried GP posts, supplementing my GP sessions with paediatrics and teaching work as I moved around following my husband’s career.

About three years ago we moved to the outer London suburbs. My youngest child was starting school and I felt the time was right to increase my hours and become a GP partner.

Partnership plans foiled

What I had not factored into my plan was that post-new GMS contract, many partnerships no longer wanted to promote younger GPs to partners.

A couple of practices did offer me salaried positions while I was doing locum work. These were for less than my earnings five years previously and on terms not as good as the model salaried GP contract.

I was not happy at the thought of being a salaried GP for the next 25 years, with no prospect of developing management skills or becoming a GP trainer.

Early this year I saw Greenbrook’s advert for a lead GP at a new GP-led heath centre in Surrey. Although the post was salaried, it would give me the chance to broaden my skills.

Greenbrook is a GP-led company that evolved from a west London practice. I met the Greenbrook team and was impressed with its offer: model salaried GP contract, better than average salary and NHS pension scheme. So here I am six months later.

I spent my first two months working with the business and clinical directors preparing to open the Ashford Health Centre, which is a completely refurbished building with state of the art facilities including on-site radiology. We opened our doors on 1 July.

The team includes three other salaried GPs, 10 emergency nurse practitioners, a business manager and Greenbrook’s hands-on senior managers.

The walk-in centre deals with all minor illnesses and injuries and opens 8am to 10pm seven days a week. We see 70 to 100 walk-in patients a day, and the challenges are many and varied.

It has been a wake up call to be thrown into the front line of unscheduled medicine again.

Some local residents still mistake us for a full A&E – we are on Ashford Hospital’s site – so we see more than our fair share of acute MIs and so on. Our nurse practitioners are highly skilled in A&E and the hospital’s A&E unit provides support.

Re-awakening old skills and working with nurses as true team members is refreshing. And local residents love having walk-in access to a GP seven days a week.

With four permanent GPs at the new practice, we can offer continuity of care with appointments available 12 hours a day, 365 days a year.

Anyone in our catchment area can register and we go out of our way to help homeless and other vulnerable patients who can find registering with a practice difficult.

We are already exceeding the PCT’s target for annual patient registrations.

Each GP is encouraged to develop a specialist skill for which training is funded. Alongside chronic disease management and QOF work, on the walk-in side we manage all illnesses for all ages.

With the nurse practitioners’ support, our injuries management includes fracture diagnosis, plastering, burns, laceration sutures and so forth.

Clinical responsibility

As part of developing integrated care pathways, we are bringing in community-based services including teenage sexual health clinics, district nurses, physiotherapists and counsellors. There are also plans to bring in some secondary care clinics – such as cardiology, genito-urinary and dermatology.

As GP lead I have clinical responsibility for the GPs and nurses. I spend half my time on management and half working clinical sessions. I run the GP rota, the in-house appraisals, clinical protocols development and have day-to-day responsibility for clinical governance.

I can also work with Greenbrook’s management team on new business ideas.

For GPs with extensive clinical experience but frustrated by the lack of partnership opportunities, GP lead posts at Darzi centres offer a lot.

Chance to develop

Working alongside colleagues with extensive business experience means I can learn management skills from experts. Working with a young, innovative company allows me to develop ideas to improve patient care and accessibility.

There are very few downsides. The main one is the seven-day a week shift system, but this is a small price to pay compared with the other opportunities.

For GPs worried about plunging into the world of private providers, I say go for it. Do your research, make sure the company is offering the model salaried GP contract (and, if possible, the NHS pension scheme), and that the management team is genuinely responsive to clinicians’ ideas and needs.

What do you stand to lose?

Dr Johnson is a salaried GP lead in Ashford, Surrey.

ASHFORD HEALTH CENTRE

GP-led health centre: Run by private company Greenbrook Healthcare (www.greenbrook.nhs.ac.uk) which operates six other GP practices near west London.

Location: Ashford, Surrey.

Staff: Include GP lead and three other GPs; 10 emergency nurse practitioners and a business manager.

GPs’ employment terms: Model salaried GP contract, NHS pension scheme, funding for GPSI training.

Opening hours: GP surgery: appointments 12 hours per day, 365 days a year. Walk-in clinic: 8am to 10pm, 365 days a year.

Future plans: District nurses, counsellors and physiotherapists; teenage sexual health, cardiology, genito-urinary and dermatology clinics; further developing integrated models of care.

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