The Cuckoo Lane Practice

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The Cuckoo Lane Practice

• Londons First Nurse Led Social Enterprise
  General Practice

Anne Hamerton BSc, RN, HV, DN September 8th 2006
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Cuckoo Lane Health Care

• Carol Sears Anne Hamerton
• Nurse Practitioner Practice Nurse
• Clinical Governance Lead Operational Lead
• Director Director
• Mahua Namdi
• Business development
• Non -executive Director

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Aim of presentation

• Story so far
• Drivers to create model
• Explain the Patient experience
• Description of GP involvement
• Why APMS with a Social Enterprise

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Story so far

• Successful Social Enterprise General Practice
  since April 2005
• New and enterprising way of working, using a team
  approach, to deliver top class primary care
• List size of 4,300 patients, all run from an
  extended 3 bedroomed semi-detached house

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Drivers for change

• Doctors resigning
• Changes in societys expectations
• Role and resources of the NHS
• Increasing pressure on Nurse appointments
• Balance between GP/NP appointments

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Our Vision

• Continuation of excellent, patient focused care
  already in place at Cuckoo Lane
• Model of least risk - management team needed to
  have the confidence of PCT and patients
• Model of least change - reassurance for patients
• We already enjoyed our patients affection. The
  whole team was committed to developing this into
  an inclusive and positive patient experience.

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Patient choice and experience

• 3 main groups of patient demand
• Acute illness
• Long term health conditions
• Screening of well people

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Acute illnesses

• About 7030 split NPGP
• Urgent appointments
• Acknowledging safe boundaries - skill mix
• Red flags
• Recognised pathways of care - 2 week referrals

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Long term health conditions

• Appropriate use of nursing skills
• Generic clinics(or not!) to improve access
• Expert Patient Programme
• Patient empowerment
• GP involvement for complex patients
• Linking with the Case Manager Scheme

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Screening Health Promotion

• Promoting healthy life styles
• Well woman / Family planning clinics
• Well man screening clinic
• Smoking cessation
• New patient health checks
• Cervical screening
• Child immunisations
• Travel health

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GP involvement

• GP involvement is integral to success
• Further interest generated - proposal is in
  keeping with the flexibility demanded by many
  GPs
• Freedom from administrative responsibilities,
  focus on core expertise
• Opportunities for professional development

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Added Value of the Model

• Community involvement in Primary Care
• Community focus
• Social Enterprise culture - most appropriate
• Experienced Management Team
• Financial advantages - cost effective
• Fostering innovation and economic efficiency
• Impartial - no clinical, pharmaceutical
  interests
• Skill mix

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Innovations at Cuckoo Lane

• Foot clinic
• Elderly days
• Intranet
• Web site
• E-mail prescription requests

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Social Enterprise model with business partner
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Business Partner

• ECT Group
• Financial management and business systems support
• Shared values and culture
• Cost effective support
• Impartial - no clinical, pharmaceutical interests

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Problems

• Growing out of our building
• No space to work efficiently and effectively
• Cramped for both patients and staff alike
• Keen to develop new services in line with
  government agenda.
• Need to expand our list size to improve
  efficiency

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Solution

• New site for purpose built primary care centre
  has been found, within easy walking distance from
  the practice.
• Agreement has been reached with the PCT and,
  London Borough of Ealing, who own the land.
• Designs draw on best practice
• Enterprise will be self funding
• We have support from our local community

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Future developments

• Community focused services that meet patient
  demand and improve the patient experience.
• Opportunities for professional development for
  the whole team.
• Developing business opportunities by sharing our
  expertise.

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Finally

• One years experience
• We have the vision to create a gold standard
  social enterprise solution for primary care.
• We have a unique opportunity.