Practice profile: England's largest practice
Partner Dr Richard Thompson explains how his 50,000-patient practice uses its size to win contracts, maintain continuity of care and ensure its GPs have fulfilling careers
Name Priory Medical Group, York
List size Around 53,000
Full-time equivalent GPs 40 (16 partners)
Our size is a major strength
We have more than 50,000 patients so we are in a strong position to negotiate with the CCG and local area team. If they get us on board, we can help them reach a higher proportion of their target number of patients. That said, we’re part of an informal federation, covering about 100,000 patients – we consider this the minimum to win bigger contracts.
Our main challenge is communication
It’s hard to get everyone doing the same thing, as the team is so big. We don’t have whole-team meetings very often because they wouldn’t work, so we have monthly management reports, then monthly partners’ meetings. Then partners take the messages back to each branch. Each salaried GP has a partner in a ‘line manager’-type role.
Every GP has a ‘portfolio’ career
All 16 partners have very varied roles: training registrars or foundation-year doctors; providing care under our contracts with two prisons and a local school; or running research projects.
Partners do very little business work
The practice is run by a management group made of two GP managing partners, a business partner and managers for IT and human resources. Our practice manager used to be a vice-president for an investment bank – we had to advertise nationally to find him. Our HR manager has NHS experience and previously worked in a food packaging business.
We have never had to wait to fill a vacancy
We have four or five trainees and some foundation-year doctors, and we prefer to employ new salaried GPs from that pool. Our progress scheme then invites salaried GPs to take on business work if they are interested in being a partner. We review their performance quarterly, and if they do well, we make them associate partners, with a bonus to their income and more responsibility. We also plan the partner workforce two to three years in advance so that we can anticipate vacancies.
We use locums more than we would like
We try to predict what we’ll need in six to nine months’ time, but sometimes we need locums to plug gaps. We had a period when it was hard to find salaried GPs, so we recruited nurse practitioners. The drought is over, but now we have covered ourselves to cope with urgent care demands.
We want patients to receive a ‘family doctor’ service
Although we don’t have personal lists, patients appreciate the continuity of care that we offer – we never shuffle them between branches. All our GPs work at a specific site.
Receptionists do not take phone calls
Each of the nine surgeries employs two receptionists. They take turns welcoming patients and dealing with queries, and helping GPs with clinical work. All phone calls are taken in the main office and we monitor how many calls we’ve missed and the average wait time, so we can take action to keep both numbers low.
Our QOF performance was 99.2% last year
We have an associate partner managing our QOF activity and we aim for 100%. Performance is reviewed fortnightly and we have a quick response to failing indicators. If we are falling behind with epilepsy reviews, for instance, we launch a phone campaign and get nurses in for an evening surgery to run a clinic. We design IT templates and try to put as much information in them as possible so GPs don’t need to hunt for the latest guidelines. We update them when guidance changes.