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One building and three practices

Darzi-style practising does not appeal at this new primary care facility.

Dr Dukes: 'My job was lovely, but now I'm thinking a little bigger because the space is there and we can add to things'
Dr Dukes: 'My job was lovely, but now I'm thinking a little bigger because the space is there and we can add to things'

'Darzi' is almost a rude word to three Grimsby practices that have moved under the one roof.

Littlefield Surgery, Field House Medical Centre and the Woodford Medical Centre moved into the £14 million Freshney Green Primary Care Centre in August this year.

Dr Nathalie Dukes, a salaried doctor at the Littlefield Surgery, says the practices may share a space with other services but they are far removed from a Darzi clinic. 'We believe in GP-led general practice and so do our patients,' she says.

All three teams continue to work separately, with patients only seeing the GPs at the surgery where they are registered.

Reasons for relocating
The move came about when the practices' respective premises became tight for space after extensions had already been built and outgrown.

Under North East Lincolnshire Care Trust Plus's (CTP) estates strategy there had already been seven private finance initiatives in the area, so the practices considered the idea of leasing from a developer.

David Holmes, practice manager at the Woodford practice, explains: 'The idea came from us, as practices, sitting down, reaching agreement and then approaching the CTP.'

The three practices already knew each other well and belong to the same practice-based commissioning group.

Nevertheless, it was a big decision. As well as becoming more involved with two other practices, the deal meant each surgery giving up ownership of its premises. The developer, Assura, bought the three buildings formerly housing each practice. Now the practices pay it rent on a 21-year tenancy contract.

'That was the biggest leap for us. The GPs were masters of their own destiny but now they are tenants,' says Mr Holmes.

They also had to pay for the project management fees and forego their cost rent and notional rent income. Now their premises funding is used to pay their lease rent under their tenancy contract with Assura.

But the practices thought it was a fair deal, because in return, they have a state-of-the-art medical centre, designed to their specification, which is fit for purpose. A bonus for the practices is that Assura, at its own risk, added 25 per cent to the size of the centre, which can be used for expansion in the future.

Assura has plenty of experience of developing primary care buildings. But the practices were adamant that the centre must meet their needs rather than someone else's.

'We felt that if we didn't get it how we wanted it then we wouldn't move,' says Dr Dukes.

A successful move
Now they have been at Freshney Green for a few months, the practices say it was the right decision. They now have a lot of space. Minor surgery used to be performed in a treatment room; now there is an 'infection- controlled' room. Even medical students on placements at the centre have their own space.

The building's other occupants make life easier for patients. Adult social services is one of the co-tenants. This fosters better working relationships and has reduced the time wasted on missed phone calls.

Dr Derek Hopper, a partner at Field House, says it is hard to think of any disadvantages, apart from teething problems such as erratic phone connections in first few days.

Dr Dukes says the potential for developing new services is exciting because it means there is the possibility to branch out.

'My job was lovely before, but now I'm thinking a little bigger because the space is there and we can add to things,' she says.

She does not believe a merger is on the cards for the future, but Dr Hopper can see it happening.

'I don't think there will be a full merger initially, but we are not practising in three bunkers. We might look at it in a few years.

Mr Holmes believes more convergence is just a matter of time. 'Everything is up for grabs,' he says.

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