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Dr
Geldard & Partners
Walton-On-The-Naze
Practice report and plan
J. A. F. GELDARD
Executive Partner. Joined Partnership in 1976
Interests:
Diabetes
Dermatology
Business Management
Red Cross Medical Officer
C. L. M. BEARDMORE Joined Partnership in 1980
Interests:
Paediatrics
Obstetrics
Asthma
Member of L.M.C
N. D. K. ROPER
Joined Partnership April 1992. Previously Medical Practitioner in RAF
Interests:
Family Medicine
Obstetrics and Gynaecology
Psychiatry
Honorary Medical Adviser to RNLI Walton, Police Doctor
to
GP Trainer
J.H. THOMPSON
Joined Partnership February 1993
Interests:
Family Planning
Hormone Replacement Therapy
Obstetrics
Locum Family Planning Officer
G.G.R. GOUNDRY
Joined Partnership in 1996
Interests:
Functional assessment
Paediatrics
Occupational Medicine
E. LEMKE
Joined Partnership in 2001.
Interests:
Pain Management
Acupuncture
Hypnosis
C. KNORR
Appointed as Salaried GP 2002.
Interests:
Anaesthesia
Management Structure
The
Management of the Practice is governed by principals and policies made by the
Partners. These policies are then used by the Executive Partner in consultation
with the Practice Manager, to provide working policies within the Practice.
PARTNERS
*
Executive Partner
*
Practice
Manager
*
Office
Medical
Senior
Manager * Secretaries *
Practice Nurse
*
Receptionists *
Practice Nurses / Healthcare Assistant
Practice Area
The
Practice Area consists of that area 'governed' by the Town Council of Frinton
and Walton and includes:-
Walton-on-the-Naze
Frinton-on-Sea
Kirby
Cross
Kirby-le-Soken
Great
Strengths
The
Practice has two purpose built surgeries, the main premises being in the centre
of Walton, and other premises being in Kirby Cross.
There
are no other surgery premises in either of these two places. The practice
continues to grow in patient numbers despite minimal development in housing in
the area over the last ten years. .
Health Visitors are based in premises
Training Practice for GP registrars and student/practice nurses.
Weaknesses
High
Workload -
Relatively low income
Until
recently main medical records were paper based
Geographical isolation from secondary care services
Opportunities
PMS
status has been granted from October 2002 including growth monies for the
employment of WTE salaried GP and ½ WTE nurse practitioner.
Switch to Electronically held records from October 2002.
Implementation of PMIP (Pathology Messaging) due December 2002.
Threats
Inadequate financial resourcing as a threat to patient care
National GP shortages especially locally, 14 doctor deficit in Tendring.
Age/Sex Profile
The
Practice list continues to grow, as it has done for the past ten years. The current list size being 9225. There is a continuing and
steady stream of patients changing from local Practices to our Practice list.
Inevitably, these patients are "active" patients; that is to say they represent
a real cost to the Practice Budget.
Ethnic Origin
The
Practice list is almost exclusively made up of Caucasian patients, "born and
bred" in the
Surgeries
There
are two surgeries run by the Practice, the main surgery at Walton-on-Naze and a
Branch Surgery at Kirby Cross (opened November 1990) serving patients from Kirby
Cross, and Great Holland.
WALTON – Surgeries are held every weekday morning and afternoon. Surgery
appointment availability ranges from 08.30 in the morning to 18.00 in the
evening. (There are occasional extended surgeries to 18.30 as advertised in the
practice booklet). In addition a Saturday emergency surgery is available to
12.00.
KIRBY
CROSS - A morning surgery is held at the Branch Surgery each day by one partner.
There is an afternoon and an evening surgery held on one day a week. The
surgeries held are regularly reviewed and will be increased as necessary.
At
the present time the Practice employs a full time Senior Practice Nurse
Practitioner, three part time Practice Nurses as well as a full time
Phlebotomist/Healthcare Assistant. The Practice Nurses provide services to
patients from
It is
current Practice Policy where possible to have specific Nurse and GP run Health
Management clinics. In order to manage demand we encourage patients to attend
clinics at the designated times, however we are happy to see patients outside
clinic times if more convenient. It is the view of the Practice that it provides
greater choice to patients if they have freedom of choice when booking
appointment times, and not to be restrictive. However this policy is reviewed
from time to time to take account of patient opinion.
In
addition to the directly employed practice staff, the Walton surgery provides a
base for the Community Healthcare Team of District Nurses and Health Visitors.
Patient Access
DOCTORS:
All
surgeries and clinics are run on an appointment system. The appointment system
is fully computerised and linked between Walton and Kirby Cross surgeries. To
comply with the 48 hour access requirements surgeries are only booked for today
or the following day. Patients are offered appointments on demand, usually with
the doctor of their choice. Appointment availability is therefore structured to
match anticipated demand. Practice policy aims are that all non-urgent cases are
seen within 2 days unless otherwise requested by the patient. Our aim is to
offer an appointment with an appropriate healthcare professional within 48 hours
of demand.
NURSES:
The
majority of Nurse consultations are clinic based
appointments for lifestyle management (CHD, Asthma, Diabetes) or for general
medical services (Immunisations, CHD, Cytology Screening, Family Planning, etc).
The remaining surgeries are for general nursing, (dressings, BP checks, minor
casualties). In addition our
Nurse Practitioner provides a daily minor illness clinic for patients who do not
necessarily need to see a GP.
Clinics
Paediatric clinics are run at Walton on a weekly basis. A Nurse is in attendance
during these clinics and the Health Visitor provides a drop in service. Full
Child Health Surveillance and appropriate immunisations are carried out at both
surgeries.
The
Practice Nurses see patients for Well Person checks, Dietary advice, and
follow-up of Hypertensive's, Diabetics and Asthmatics. They also see patients
for Family Planning advice. Ante-natal, Post-natal and Minor Surgery
appointments are incorporated in normal surgery times and not run as specific
clinics. Chronic patient management protocols are followed having been agreed
with the PCT.
On Call Cover
On
call is provided by each partner on an equitable basis. Some partners choose to
do their own on-call work and other partners make use of the service provided by
Healthcall.
Targets
Since
implementation of the Immunisation and Cervical Cytology target payments, the
Practice has attained the higher level target in both categories each quarter.
This has been possible due to well established recall systems for immunisation
and cervical cytology in operation for some years.
The
immunisations management system is run by Practice Nurse Tracey Stevens. Whilst
the higher target figure is still being achieved the practice is noticing
increased resistance to MMR vaccinations.
The
cervical cytology management and recall system is run by Melanie Willis, Medical
secretary. Again the higher target figure has been attained from inception, the
percentage of adequate cervical smears averages at 83 %
Existing Premises
The
Practice consists of the main surgery premises at
The
Walton Surgery opened on
The
purpose-built Kirby Cross Branch Surgery opened on
Both
surgeries are fully equipped to necessary and expected standards. Equipment
includes:
2
Electrocardiograph
1
Electric Cautery
1
TENS Machine 1
Defibrillator
1
Audiometer
2
Autoclaves
8
Nebulisers
1 Portable Oxygen
4
Resuscitation Packs
6 Wrist BP Monitors
2
Dopplers (foetal heart/vascular head)
2
24 Hour Ambulatory BP Monitor
Proposed Developments
The
Practice recently upgraded its practice computer network to EMIS Version 5.2. to facilitate electronic paper record and PMIP
implementation.
The
switch to electronically held records was made only recently, October 2002.
The
next major step is to convert manually held summaries to the clinical system.
The Practice considers that electronically held data is now an essential
requirement in the team management approach to patient care as well as providing
the necessary auditing tools for monitoring health trends and practice
efficiency.
Expected before the end of 2002 is the commencement of the roll-out
programme for PMIP for
Individual tailored performance appraisal will commence in April 2003 with the
first PDP’s for staff. Appraisals for this year will take place in February 2003
as a dry-run exercise. These are designed to familiarize staff to the appraisal
process and to establish standards/expectations/training programmes for the
coming year.
The
Practice switched to PMS in October 2002 securing growth monies for the
provision of a salaried GP and part time Nurse Practitioner. The practice
intends to use these resources to further enhance patient services by extending
availability of healthcare access in line with the open access directive. It is
intended that this will also extend to patients currently excluded from some of
our services by their inability to get to surgery based clinics.
Training Facilities
We
are a training practice for GP registrars and Nurses.
Registrars are appointed annually and work within the existing practice
structure under management of the Practice Trainer, Dr Roper.
Student Nurses are posted for shorter periods to observe and learn specific
aspects of practice nurse work. Training is carried out by Wendy Mitchell and
Elizabeth Maythan.
PRACTICE STAFF
NURSING
Senior Practice Nurse Practitioner:
Mrs Wendy Mitchell. RGN.
Reports to Practice Manager
Responsible for set-up and running of clinics, management of Practice
Nurses and all Practice Nursing.
Asthma lead
Family Planning Trainer
Qualified Nurse Practitioner
Chronic Heart Disease
Practice Nurse:
Mrs Elizabeth Maythan RGN.
Reports to Senior Practice Nurse
Diabetes Lead
Asthma
CHD
Family Planning
Practice Nurse: Mrs Tracey Stevens RGN.
Reports to Senior Practice Nurse
Chronic Heart Disease Lead
Diabetes
CHD Lead
Practice Nurse: Mrs Angela Howard RGN.
Reports to Senior Practice Nurse
Healthcare Assistant: Mrs Beverley Rogers.
Reports to Senior Practice Nurse
ADMINISTRATIVE
Practice Manager
Mr Martin Durrant.
Reports to Executive Partner
Fully
responsible for day to day running of the Practice, appointment and training of
staff, Practice accounts and staff salaries, computer, discipline, planning,
liaison with patients and outside bodies.
Office Manager
Miss Jennifer Wright.
Reports to Practice Manager
Responsible for the running of the Reception Office at both surgeries, assists
in appointment and training of staff, specifically responsible for Child Health
Surveillance administration and Insurance Company clerical work.
Medical Secretary
Mrs Bernardine Howe
Reports to Practice Manager
Responsible for all secretarial provision for the Practice.
Medical Secretary
Mrs Melanie Willis DPA MAMS
Reports to Practice Manager
Responsible for secretarial provision for the Practice, smear call and recall
system.
Receptionist
Mrs Diana Clarke
Reports to Office Manager
Undertakes all Reception duties.
Receptionist
Mrs Elizabeth Burridge
Reports to Office Manager
Undertakes all Reception duties.
Receptionist
Miss Emma Coyne
Reports to Office Manager
Undertakes all Reception Duties
Receptionist
Mrs Jenny Edwards
Reports to Office Manager
Undertakes all reception duties
Receptionist Miss
Juliet Wright
Reports to Office Manager
Undertakes all reception duties.
Receptionist Mrs Bernadette
McGowan
Reports to Office Manager
Undertakes all reception duties.
Receptionist Mrs
Nicola Chapman,
Reports to Office Manager
Undertakes all reception duties.
Receptionist Mrs Paula King
Reports to Office Manager
Undertakes all reception duties
Receptionist
Miss
Claire Fisher
Reports to Office Manager
Undertakes all reception duties
Receptionist Miss Natalie Harrison
Reports to Office Manager
Undertakes all reception duties
The
Practice is fortunate in having a competent, well-trained and friendly staff.
Within the existing staffing there are personnel with the appropriate skill
mixes to manage the increased work load and different skills required.
TECHNOLOGY AND INFORMATION SERVICES
Computer systems in operation
The
Practice has a fully networked EMIS computer system. The main system is linked
to the Kirby Cross branch surgery via a Kilostreem line. Terminals are situated
in all working areas and are accessible by all practice personnel. Each member
of the Practice is fully trained in its use with periodic updates as system
developments roll out.
Computers were first installed in 1990 but played only a minor role in the work and management of the Practice. Initially only appointments and repeat prescription processing were converted to system functions. In 1999, the system was changed to the current supplier and since then there has been a steady increase in the recording of clinical data. In October 2002 the practice took the decision to dispense with manually held data, recording instead all information onto the clinical system.
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