From Dr Arvind Madan, GP Partner
We had no particular plan to grow. Till 2006 we ran our 12,000 patient surgery in South London, feeling proud of our 100% quality points score, substance misuse service and willingness to go the extra mile for our patients. The Commissioners then asked us if we would support two local single handers with recruitment and premises issues, which we did. One thing led to another and we found ourselves starting a new practice for a new population in Vauxhall.
Southwark PCT decided to divest itself of a PCT-run practice in Peckham and the staff there encouraged us to apply. The clinical and operational turnaround of this troubled practice took us a year. The Nuffield did an analysis of our positive impact, and we were asked to caretake a neighbouring practice at short notice. A few months later we were awarded the contract for the practice and a Walk-in Centre at the same site. We soon developed a passion for the satisfaction derived from taking a struggling service and transforming the care for patients, and just kept going – always keeping our focus on London’s most deprived communities.
We now run 13 practices in 10 London Boroughs with 100,000 registered patients and 350,000 minor illness and injury cases from nine locations. The team has grown from 25 to nearly 400 in this period, but we remain a traditional NHS GP Partnership model. Along the way, we branched out into providing substance misuse services, a sick doctors service, developing several premises schemes, and delivering a school health education and anti-bullying programme (provided by the six school teachers we employ). We also developed partnerships with social enterprises to impact the wider determinants of health in our communities e.g. Chapel Street, Praxis and Turning Point.
More recently, we have taken on 111 GP call handling and Out of Hours services, as well as developing technology for use in Primary Care. These include an online platform called webGP for patient self-management and eConsults, and another allowing clinicians and managers to source online advice and share best practice. We are finding that these not only improve the patient experience, but also improve practice capacity for more complex patients.
Our growth has been rapid and we have learned a lot over the last few years. The thrill of feeling like we are making a difference to the healthcare of our populations more than compensates for all the hard work. We have had to grow up as a larger GP provider. We monitor our own access, health outcomes and cost effectiveness using a comprehensive dashboard which tracks performance by site every month. We survey our patients extensively and ensure their voice is at the heart of our offer and service blueprint.
Our model is heavily influenced by our team to ensure morale remains high and we remain focused on our organisational purpose – delivering the best care to the most deprived communities in London. We have a robust organisational development programme for nurturing talent and attractive career pathways for all clinical and non-clinical staff. We invest in education, training and research and are developing the Hurley Academy to host our in house mentoring, leadership and skills training programmes.
Having influenced the Primary Care Standards and the initial design of networks in Tower Hamlets in 2007, we now find ourselves in an emerging world of cross-practice provision. We are members of numerous Federations and involved in several discussions about capitated and pooled budgets with others. The next challenge will be navigating our way to a model that is right for patients, general practice and the wider sustainability of the NHS.
Dr Arvind Madan
GP Partner | Hurley Group