Pitsmoor Surgery
151 Burngreave Road
Sheffield
S3 9DL
Telephone: 08451 222231
Fax: 0114 276 0169
Partners
Dr Trish Edney, Dr Hugh McCullough, Dr Clare Richardson, Dr Will Carlile, Dr Amar Bal, Dr Alison Hobbs, Dr Jennie Joyce, Dr Catie Nagel and Mr David Emmas
Salaried GP
Dr Doerthe Kempke
Trainers
Dr Hugh McCullough and Dr Amar Bal
Practice Staff
Clinical
The clinical team consists of eight GPs, two of whom are GP trainers (Hugh and Amar), three practice nurses and three health care assistants. The nurses are Rose Hawkins, Alison McGrail and Nicola Beveridge,; Mandy Hawkins, Lisa Martin and Heather Bond are the health care assistants.
The practice employs a Mental Health Worker and a 2 Support Workers.
Attached to the practice are a large group of health workers, including the District Nurse team, Health Visitors, Midwives, Chiropodist, Counsellor & Physiotherapist.
Administration and Management
The team of eight receptionists is led by Julie Martin and carries out the challenging task of meeting our patients and managing their contacts with the practice. This task is demanding and complex – and especially so since the introduction of access targets, which has resulted in major changes in our systems. We are very keen that our trainees experience this ‘sharp end’ of practice working early in their attachment.
David Emmas is the practice manager and he is supported by a personal assistant (Lynn Battersby), a secretary (Pam Thomson), IT administrator (Jamie Mathews) and Medical records Administrator (Sharon Emmas). An able practice manager is key to successful general practice and GP registrars have much to learn from him about change management, our relationship with the PCT and the future of the NHS.
Patients
Pitsmoor and Burngreave is a lively inner city area with a diverse multi-cultural population. In recent years many asylum seekers and refugees have arrived in the area – and they often have major physical and psychological problems. Our area has benefited enormously from the government initiative New Deal for Communities, which has injected a substantial amount of development money into Pitsmoor. Community groups have sprung up to bid for this money – offering a whole range of projects ranging from adult education and street crime initiatives to art and cultural groups and gym facilities.
Here are some facts about the practice:
- List size 8,700 and increasing (this equates to 9700 after weighting)
- High mobility with over 1000 patients new to the practice in last 12 months
- There is quite a socio-economic mix, but 45% of patients live in areas classified as “poverty postcodes”.
- 15% from an Afro-Caribbean background, and 10% of Asian origin.
- We serve a significant number of specialist accommodation providers such as women’s refuges and hostels for the homeless, those with psychiatric and learning disabilities, young mothers, etc.
- There are 540 patients over 75 and many patients in residential/nursing homes.
The Building
- Premises built in 1988 and extended in 1997 to accommodate an enlarging primary health care team.
- A further large extension was completed in 2006 and a neighboring Victorian semi has been refurbished to accommodate our mental health workers.
- The main building now provides 15 consulting/clinical rooms, 2 reception offices, 5 administration offices, large meeting room, library, staff kitchen/rest room.
- Well equipped and pleasant to work in - with air conditioning in most rooms. There is a computer terminal with internet access in every room.
Practice Philosophy
We aim to offer:
- Patient-centred care – patients’ problems are often complex and intractable, and may be related to economic deprivation, poor education and mental illness or substance misuse. We care for and respect each individual regardless of social circumstances, race, beliefs or gender.
- We encourage a 'personal' doctor service, where a patient with an ongoing problem is cared for by the same partner.
- A team approach to caring for patients. Mutual respect for the skills and professionalism of colleagues and regular communication among team members are regarded as essential.
- A positive learning environment, - we enjoy the challenge of our work (most of the time!), and hope that our commitment and enthusiasm rubs off on those we work with. We plan to learn from mistakes when things go wrong, by having regular meetings to discuss significant events.
- Training – is central to our practice philosophy, and all members of the team expect to participate. We have taught nurses and medical undergraduates for over twenty years and started training GP registrars in 1996. As a training practice we aim to help every individual associated with the practice achieve his/her potential.
- Continuing practice development and education - The whole practice team participate in our fortnightly clinical and educational meetings and there are monthly whole team half day meetings (in-house PLI).
We aim to be a ‘leading edge’ practice. This means that we try to keep abreast of the rapid pace of change in the NHS – identifying those trends which will impact on our practice, and to be early adopters of initiatives which will fit our interests and benefit our practice population. We are in a good position to future gaze as Trish Edney is chair of the locality commissioning group and sits on the CET, Hugh McCullough is an Associate Postgraduate Dean and David Emmas is a highly regarded manager who has also been involved in training practice assessment.
Some examples of recent practice initiatives have been the training of practice nurses to run minor illness clinics, the recruitment of a nurse assistant, development of a system of personal assistants for GPs, take up of a PMS contract to improve care of elderly in care homes.
Training for General Practice
The practice can routinely accommodate three doctors in training offering a mix of training places. A group of three registrars offers opportunities for joint teaching and peer learning which we hope to develop – for example some joint tutorials, video consultation analysis and case discussion. We think that a more ‘corporate’ approach to training will enrich the trainees experience by exposure to all the trainers and other staff and to each other; however we firmly believe that the strength of GP training is the personal teaching relationship between trainer and registrar, and we are determined to preserve this.
Training Programme
Like most training practices, we offer a standard training programme which includes an induction period, daily debriefing, weekly tutorial and attachments to the different primary health care team members etc. We are very keen on teaching consulting skills and favour joint surgeries throughout the training period and frequent use of video. All doctors now need to keep evidence of learning for appraisal purposes, and so we expect our registrars to take responsibility for maintaining teaching and learning records. The trainers will contribute to this record – probably electronically.
We approve of the MRCGP exam and preparation for it forms a very constructive agenda for the first three months of the second attachment in general practice.
Training Opportunities at Pitsmoor
The practice offers all the usual services that are provided by a general practice. However there are several fields of special interest – usually linked to one of the partners, and all trainees are encouraged to get some experience in these areas during their attachments. As GpwSIs appear to be in demand, registrars might consider preparing for such an additional role by spending an extra six months in an ITP post in one of these areas.
- Mental Health. The practice has high prevalence of patients with enduring mental health problems – about five times the expected rate. In 1996, Will Carlile obtained funding for the Pitsmoor Mental Health Project to provide better care for this group of patients. (The Project won the Sainsbury Mental Health Prize in 1998. Recently the project gained funding from New Deal for Communities to start a gardening project ‘Greenfingers’ based on the local allotments.
- Care of the Elderly. Alison Hobbs and Jennie Joyce look after twenty four ‘step down’ intermediate care beds in 2 local nursing homes which follow a programme for elderly review in local care homes devised by Alison.
- Diabetes. The practice has run a programme of structured care for people with diabetes since 1988. The practice team has taken part in a city-wide pilot for managing the care of people with Type 2 diabetes on insulin and also initiates insulin in people with T2DM. Hugh McCullough is the clinical lead for diabetes in NPCT.
- Child Health. The practice has developed an integrated approach to child health by running a well attended weekly baby clinic and team meeting which is attended by the lead GP, health visitor, practice nurse – with monthly visits from the CPN for child mental health and the community midwife. Clare Richardson chairs this meeting which aims to identify families at risk and divert extra help to the children.
- Learning Difficulties. There is a high concentration of care homes in Pitsmoor and provision of medical care is inadequate. This is an area that we would like to develop.
Summary
So what is a registrar to expect from this post? We would summarise the experience as challenging hard work in a structured, friendly and supportive environment where you will feel that your contribution can make a real difference. We will train you to be an effective GP and hope to give you attitudes and skills so that you can keep yourself enthused, engaged and up to date throughout your career.
To learn more about training at Pitsmoor
Contact David Emmas to find out more about the practice and to arrange an informal visit. David can also put you in touch with former registrars who can probably give you a more detailed and relevant picture of the practice.
Email: davidemmas@nhs.net