Hackney GP Training practices

Lower Clapton Health Centre

The Lower Clapton Group Practice is a nine-partner practice (includes full-time and part-time partners) in Hackney. We work from a purpose built health centre in an inner city area with a mixed but predominantly working class population. We have patients originating from more than 75 different countries although most of these are Afro-Caribbean, Turkish and Asian. The population is highly mobile, with a majority of younger patients. There is a 25% annual turnover of patients in our practice. Hackney has the highest scores in the country on a number of indices of social deprivation with a disproportionate number of people who are homeless, living in poor conditions, single parents, socially isolated or unemployed. On the other hand, our surrounding community is also culturally rich and an exciting place in which to work.

Most of our patients live within a mile of the Health Centre. We accept anyone who wishes to register if they live in our catchment are and only remove those who live too far away. This means we have a fair number of patients with complex problems! We also provide general medical services for several psychiatric hostels, a community home for the severely mentally handicapped and a residential home for the elderly. Our current list size is approximately 10,500 patients. We have two Registrars, one Pre-Registration House Officer and employ a Practice Manager, Assistant Practice Manager, five full-time and one part-time Receptionist, two part-time Secretaries, one full-time Head of Reception and another part-time, both with administrative responsibility, two Administrative Clerks, one part-time Book-keeper, three Health Promotion Nurses and a part-time Counsellor, Art Therapist and Eurythmist. Attached to the practice are a team of community Midwives, two Health Visitors and one District Nurse. We also have a Drugs Counsellor. There are regular team and partners meetings and case conferences.

We are a University linked practice, with access to Medical School IT facilities.

On weekdays we run morning, afternoon and evening surgeries mainly by appointments at ten minute intervals. Each session also has an on-appointment "emergency" surgery to improve access of acutely ill patients. We have one doctor emergency-only surgery on Saturday mornings, for registered patients living locally. We are part of the Hackney Doctors on call co-operative, providing out of hours emergency cover, when the surgery is closed.

Apart from the normal surgeries we run two Child Health Clinics for patients and one Antenatal Clinic per week. The latter is part of a district-wide scheme of community based Antenatal care. We do the initial booking and all subsequent care from two hospital visits at 16 and 34 weeks for all patients without complications. We also provide Obstetric care for suitable women who request it. Although generally we do not intent to expand the number of Doctor-run "special clinics", preferring to provide focused care within the context of normal surgeries, we do run a successful twice-monthly Diabetic Clinic with Nurses, a Dietician and a Chiropodist. We have recently started Nurses-run Health Promotion Clinics, which provide a disease risk screening and health education service, as well as ongoing care for patients with chronic illness. The Health Promotion Nurses also run stop-smoking and healthy eating groups.

The practice as a whole is committed to teaching and training. Three of us are approved GP Trainers and we generally have two GP Registrars in the practice at any time. We also regularly teach groups of medical students and have other health care professional visiting the practice.

One partner is Professor, another Reader in the Department of GP, giving a strong academic and research emphasis to the practice. We are a member of the ELENoR network of research practices. One of our partners co-chairs the Executive Committee at the City and Hackney PCT, and all partners have their own special interests and commitments, these include clinical management, protocols and guidelines, GP representation, commissioning of secondary services, occupational health, psychiatry of old age and medico-legal issues.