Chloe WebsterChloe Webster is a 4th year medical student, a yogaholic, creative writing enthusiast, and an aspiring future GP. You can read more of her articles.

Is Lakeside Leading the Way?

Times are changing. Long gone are the days of semi-detached houses in the suburbs being home to the family doctor. I cast my mind back to Meadowside, my childhood practice. The rickety wooden gate creaks open, with each gust of wind which whistles by. A small winding path guides you to the front door. The living room has been converted in to a waiting room, with patient information leaflets scattered over the marble-stone mantlepiece. Above, instead of an ornate mirror or painting, hangs a computer screen displaying health information like propaganda. The magnificent fireplace stands proud. To the left is a small alcove. It is filled with children’s toys: old ladybird books, an assortment of pieces of Lego donated by a patient, and those infamously noisy wooden bead mazes. A small wooden base, various wavy wires, and chunky building blocks for the children to weave through the maze. Oh, how noisy they are.

A small practice now fighting, like so many other surgeries in the area, to survive. Their only chance of survival is merging…

The central staircase winds, climbing higher and higher. The small single bedroom at the top of the stairs being the consultation room for the newly-employed GPST3. The door scrapes past the furniture as the next patient enters. There are only a handful of GPs at the practice: everyone knows their names. The familiar face we see each time we go to the surgery, who knows all our ailments, Granny’s weekly bridge score and the name of our golden retriever. A small practice now fighting, like so many other surgeries in the area, to survive. Their only chance of survival is merging, losing their beloved identity to the patients they care for, to become a ‘super practice’.

At the other end of the spectrum, I give you Lakeside Surgery, Corby. Located in a small Northamptonshire town, it is a practice like no other. There is a quiet little boating lake surrounded by a wall of fir trees. The water is still. It is a place of serenity. It is a different story on the other side of the road. Through the man-made hole in the trees, only a stone’s throw away is Lakeside Surgery. “The largest GP-lead ‘super practice’ in the NHS”[1] caring for over 100,000 patients, with plans to expand their services to the care of over 300,000[2].

I looked down to see myself dressed in scrubs, with my bright green trainers, based on a ward.

A booming practice, equipped with over 25 GPs, an Urgent Care Centre, an observation ward, an X-ray Department and a biochemistry lab. I was taken aback on my first day. “This can’t be a GP surgery?!”, I thought, reminiscing to my family practice. Looking back, Meadowside seemed almost backwards compared to Lakeside. I remember my short time spent in the Urgent Care Centre, known colloquially as the 8-2-8. I felt so lost. I looked down to see myself dressed in scrubs, with my bright green trainers, based on a ward. I had to keep reminding myself that this isn’t a hospital: This is a GP Surgery.

In 2015, with over 700 patients attending Accident & Emergency each day, Leicester Royal Infirmary appointed Lakeside Surgery to “see, triage, treat or stream all ED ambulatory patients”. Richard Mitchell, CEO of Leicester’s Hospitals stated that 200 of the 700 attending the Emergency Department each day required urgent treatment, but this could be provided elsewhere.[3] The never ending influx of patients, in one of the worst Emergency Departments in the country, left its staff feeling “utterly powerless” [4].Is the ‘Lakeside Model’ the answer to the crushing strain on our hospitals? What started as a 5-year vanguard pilot is now a booming, built for purpose ‘super-practice’ offering both primary and secondary care services by 62 GPs to a patient list planned to triple to 300,000.[5]

Is this the future of general practice? Will the overwhelming demand on secondary care lead to GP surgeries having to provide more and more acute services? Are GP surgeries becoming mini-hospitals?

With the celebration of the 70th year of the NHS, are we saying farewell to the traditional view of general practice?

 

References:

[1] NHS England.  Lakeside Healthcare (Northamptonshire [Internet].; [cited: 22nd March 2018]. Available from: https://www.england.nhs.uk/new-care-models/vanguards/care-models/community-sites/lakeside/

[2] GPOnline: GP Super-Practice to run ‘front door’ at busiest A&E in England [Internet].; [cited 24th March 2018]. Available from: https://www.gponline.com/gp-super-practice-run-front-door-busiest-a-e-england/article/1372058

[3] Leicester Hospitals: Leicester Hospitals appoints Lakeside to run their Emergency Department ‘front door’ [Internet].; [cited: 24th March 2018]. Available from: www.leicestershospitals.nhs.uk/aboutus/our-news/press-release-centre/?entryid8=37920

[4] BBC: Expert to tackle Leicester Royal Infirmary’s poor emergency care [Internet}.; [cited: 31st March 2018]. Available from: http://www.bbc.co.uk/news/uk-england-leicestershire-27828544

[5] Pulse Today: Largest GP practice in the country set to cover 100,00 patients [Internet].; [cited 31st March 2018]. Available from: http://www.pulsetoday.co.uk/home/finance-and-practice-life-news/largest-gp-practice-in-the-country-set-to-cover-100000-patients/20020076.fullarticle

 

Featured image: Hannu Keski-Hakuni