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At the heart of general practice since 1960

GPs concerned on confidentiality

Practice business manager Deb Farnworth-Wood became one of the first managing partners in general practice in 1995 ­ she explains how the last 10 years have been

Initially I was reluctant to accept the partnership offer. This was because prior to joining the practice as its business manager I had enjoyed a fast-track career in the private sector. My longest time in any one post had been two years and in one company I'd had three promotions in three years.

I really enjoyed the challenges of change and could not imagine I would stay in one organisation for very long. Eventually, though, the doctors persuaded me and I accepted. Despite my reservations, the last nine-and-a-bit years have been extraordinary. I have thrived on every minute of the work.

My role as 'managing partner' is constantly evolving and changing. We have grown into a much larger organisation, and also own our own pharmacy and minor surgery company, so I have never felt stifled or bored being in the partnership. The other partners have also allowed me the flexibility to develop new skills, explore new avenues and undertake consultancy projects too.

We are a practice that thrives on being at the forefront of development and being in such a stimulating environment has been challenging, exciting and fun. We boast a string of 'firsts': first-wave fundholders, the first practice in England to buy its own pharmacy and the first group of six GPs to obtain fellowship by assessment accreditation simultaneously ­ to name only a few.

In the past decade we have also bought and sold residential property, developed phlebotomist, health care assistant and nurse practitioner roles, introduced nurse-led urgent clinics and developed autonomous working teams in the reception and general office.

We are also very much at the forefront of IT development. We have been paperless for 12 years in clinical practice and have trialled (and rejected) a state-of-the-art robotic dispenser ­ at the time there was only one other, in a UK community pharmacy.

We have introduced a patient's touch screen check-in computer system and have developed our websites (one for each company) to provide greater flexibility for patients by offering a wide range of online services. Our pharmacy website allows patients of other practices to let the staff know that there is a prescription to collect for them at another surgery.

In 2003 we were looking to expand, and it took exactly 10 minutes for the partnership to agree to buy a large factory premises. So for 18 months my key focus was its development and conversion to a new centre.

In August last year we moved the whole of the practice into the new £2.5 million one-stop-shop we bought, planned and developed ourselves. The new centre also incorporates a seven-chair dental unit, the Somerset podiatry and dietetic services, a theatre suite, a complementary therapy centre and our pharmacy, and still has room to spare!

We are also a practice that believes in quality of life and we actively encourage each other to develop outside interests and skills. I have been able to undertake a variety of consultancy work; some of the more challenging tasks have been crisis management for a partnership in dispute, an orthopaedic project looking at the reasons for disparity in GP referrals, and a waiting list management project.

Other partners in the practice are trainers and some are involved in research. We also have one who is a course organiser, one who is an LMC representative and one who qualified as a barrister at the Inns of Court Bar School during a 12-month sabbatical!

I feel I am lucky to be in this partnership. We take care of each other and take the time to ensure that we all feel good about what we do. When the GPs felt they needed another partner to share their workload they immediately offered me a PA to help with mine. I have the same benefits as the GPs ­ study leave, sabbatical and holidays.

As the organisation expanded, my PA, Rachel, was promoted to practice manager. I take care of all the business aspects and, with Rachel, day-to-day operational management of the organisation which leaves the doctors free to concentrate on clinical issues and clinical development.

We have regular evening meetings every four to six weeks (we take it in turns to visit each others houses with a takeaway!) as well as monthly business meetings at the practice.

This means we have both structured time for formal decision making and time for brainstorming and relaxed discussion.

And the future? Well, we are not known for stagnation! We are currently developing a patient information system that will be projected through a plasma screen in the waiting room and for the past year have been working with a software company advising development on practice requirements for GMS2 monitoring, SMS messaging and also trialling PCT asset management software for them.

The pharmacy has just launched a delivery service and we have just recruited a second nurse practitioner as part of our strategic move to a new model of care.

Deb Farnworth Wood is managing partner at New East Quay Medical Centre, Bridgwater, Somerset

What we've done over the last

nine or so years

·Arranging to become first-wave fundholders

·Purchased pharmacy

·Purchased and resold residential property

·Developed phlebotomist role

·Developed health care assistant role

·Developed nurse practitioner role

·Introduced nurse-led urgent clinics

·Developed autonomous working teams

in the reception and general office

·Moved on IT development

·Trialled (and rejected) a state-of-art

robotic dispenser

·Introduced a patient's touch screen

check-in computer system

·Developed various practice websites

·Moved practice to new premises

·Developed consultancy skills outside practice

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