• Community Integrated Healthcare – Whitstable Medical Practice
• Croydon Intermediate Gynaecology Service – Norbury Medical Practice
• North East Lincolnshire Care Trust Plus – Raj Medical Centre/North East Lincolnshire Care Trust Plus
Winner – Whitstable Medical Practice
Whitstable Medical Practice is an outstanding example of community-integrated healthcare.
It was described by Dr David Colin-Thome, previously national clinical director for primary care, as ‘a most brilliant practice that builds on the strengths of traditional general practice and also offers an impressive range of extended services’.
He added: ‘Whitstable is as good a primary care organisation as I have seen, and arguably one of the very best.’
The practice, says executive partner Dr John Ribchester, ‘involves service redesign, not merely service relocation’ and is often cited as an example of how community-integrated healthcare can work.
Whitstable Medical Practice is a pathfinder practice of 18 GP partners that cares for a population of 33,000 patients from three medical centres in Whitstable, Kent.
It has redesigned some of the provision of clinical care in Whitstable to achieve a better-quality patient experience at less cost to the NHS, providing an extensive range of healthcare services integrated within the practice.
• outpatient clinics with nine attached consultants, seven GPSIs and a hearing clinic
• community diagnostics, including digital X-ray, ultrasound and echocardiography
• a day surgery suite providing cataract surgery, endoscopy, carpal tunnel decompression and dermatological surgery
• a minor injury unit with an X-ray, open
12 hours a day every day of the year
• a physical therapy service with physiotherapy, acupuncture and chiropractic.
A Better-quality patient experience
This service redesign has led to shorter waiting times and easier access for patients, with one-stop clinics where possible, assisted by on-site diagnostics.
Patients enjoy consistency of consultants and GPSIs – which leads to fewer outpatient follow-up attendances – in a newly built, patient-friendly setting. This is all done at reduced cost to the NHS as most outpatient clinics, all GPSI clinics, MIU attendances and all day surgery is provided at less than tariff, typically at 75%.
Whitstable Medical Practice’s success in reducing follow-up attendances and referrals to secondary care has further reduced healthcare costs.
Long-term condition management is enhanced by the community outpatient clinics and diagnostics.
Pathway redesign with an emphasis on appropriate work-up prior to one-stop clinics has enabled faster diagnosis and treatments. A minor injury unit is co-located with an ambulance response base, which has enabled better care through enhanced communication.
Rehabilitation and recovery following injury or surgery is now provided locally, with faster access and better integration through physical therapy services.
Satisfaction surveys score the GP provider services very highly.
The future of primary care? A working model proving better access reduces unscheduled demand.
Dr Peter Weaving, diarist, Practical Commissioning