Hackney GP Training practices

The Lea Surgery

History

Dr A Goel took over the practice on 1.1.2001. Initially the practice had 1767 patients and we provided care from a portacabin. Since then, we have completed 2 moves, hopefully the last for a while and grown dramatically, particularly since taking over a retired GPs list in April 2003. Now the list stands at 4900 and we are practising from superb new premises.

We have expanded the range of services and the use of IT, being paperless now. In that time we have also been approved as a training practice for both GP registrars and nurses. Our first GP registrar started in August 2003. We went live as a PMS practice in April 2003.

Practice Population

We have 4900 patients, who are incredibly diverse in terms of ethnicity and deprivation. Patients range from managing directors of large companies to asylum seekers. The population is quite young with relatively few housebound patients and minimal demand for home visits.

Premises

We have just moved to wonderful new premises on Homerton High Street, close to Homerton station in January 2004. There are 7 clinical rooms and a staff room, providing us with the space to aspire to the highest standards and even to develop services further. We have taken the opportunity of the move to upgrade all the facilities from the telephone system to the IT, so that clinicians will work with state of the art facilities.

Staff Line Management Structure

Dr Ajay Goel is the GP principal. He qualified in 1991 from Oxford and the Royal London. He passed MRCGP in 1995 and was in a partnership in Enfield for 4 years. In 2001 he went single-handed, when he took over this practice. He has an interest in IT, clinical governance and rheumatology.

We have a part time GP working with us at the moment and are looking to recruit a further part time/ full time GP. We have weekly multi-disciplinary professional development sessions and believe wholeheartedly in professional development.

Practice Administrative Arrangements

We have a full time practice manager, a full time medical secretary and 4 part time receptionists. Most of the team have been at the surgery from the start and are highly skilled and motivated, relieving a huge amount of stress from the clinicians.

Nursing & Allied Health Professional Support

We have 2 senior grade practice nurses. Both nurses provide full family planning services and chronic disease care. In addition, Lalita has completed the extended nurse prescriber course, enabling her to prescribe for chronic diseases not just paracetemol. She is a trained health visitor and does the 18 month checks for the practice. Anna is a trained midwife and handles our maternity care.

W have an attached health visitor and district nurse. A dietician attends for the diabetic clinic and a psychologist provides a weekly on-site clinic.

For the last year, the practice has been involved in piloting the minor ailments scheme. This enables patients to obtain medication for minor ailments eg thrush, sore throats and hay fever directly from the chemist FREE. This has reduced the demand for doctor appointments and led to improved working relations between the local pharmacy and ourselves.

Services we provide:

• full maternity care
• child health surveillance
• childhood immunisation
• travel advice/immunisations
• diabetic clinics
• insulin clinics with the hospital diabetic nurse
• psychology sessions
• joint injections
• full chronic disease care including spirometry in house
• minor ailments scheme with the local pharmacy
• benefits advice clinic
• CPN psychiatric review clinic

Targets / progress towards Quality Points for the new GP contract.

We offer a routine 10 minute appointment the next working day and often the same day. This is not achieved by slogging ourselves to death. Generally a doctor will see 13-15 patients in a surgery at 10 minute intervals.

In the 2004/5 year we scored 1043.5/1050 points on the QOF, with maximum scores in the clinical domains. This year 60% of our diabetics have an HBA1c of 7.4 or less.

Prescribing

We are fully computerised for all prescriptions, acute and repeat. We generally use the PCT formulary and have a generic prescribing rate of > 80%.

Records & Computer Systems

We are fully paperless, and generally run surgeries without pulling the paper records. All our records are summarised onto the EMIS computer system. We enter all our consultations into the computer and use templates systematically. We scan all our incoming post, and have lab links functioning fully.

Opening Hours

Currently the surgeries start at 9am and the last surgery finishes at 6 pm. We are closed on Thursday afternoons for a half day. We hand over all out of hours work to Primecare. We are looking at piloting extended reception hours and the possibility of running commuter clinics in the evening eg 17.30-19.30.

We are quite flexible re the timing of surgeries and aim to provide a range of surgery times throughout the day.

General Information

We are a relatively small practice that aims to deliver high quality care with the personal touch. Being small, we can deliver more continuity of care, which is more satisfying for patients and doctors alike.

We are very flexible re working arrangements including the timing of surgeries and the possibility of extended holiday periods (by negotiation and not in school holiday periods). We would be supportive of applications via the flexible career scheme and have already been approved as a practice for the latter.

We have free parking at the practice and nearby, and we are literally next door to Homerton station. We are also very close to the Homerton Hospital, with access to its postgraduate facilities.

We would be delighted if a GP wished to test the water first by doing a locum. If anyone has any queries or would like to make an informal visit/organise a locum, then they should contact Dr Ajay Goel.