Although not a service directly for patients, GP training is nevertheless an important part of what we do. In addition to training GP Registrars we have junior hospital doctors working in the surgery for four-month attachments, and we also take on medical students from St Barts and Oxford, for fortnight attachments during the year. This page is really aimed at GP Registrars, junior doctors and students who want information about Western Elms and Circuit Lane surgeries.
Usually a GP Registrar is based at the practice for about a year, learning ‘on the job’ what General Practice is all about, and making the transition from being a hospital doctor to a community GP. The Registrar takes a full part in the running of the surgery.
Western Elms Surgery has been a training practice since 1992, when Geoff Williams became our GP Trainer. He has now retired from the surgery after 32 years and doctors Oji and Haldane now carry out this role. We are part of the Reading Vocational Training Scheme for GPs.
We believe Western Elms and Circuit Lane surgeries provide an ideal environment for training GPs. The extensive modernisation and extension of Western Elms Surgery in 1992, and further development since then, has provided the following facilities:
- A consulting room specifically for the GP Registrar(s)
- Two large and well-equipped treatment rooms, with facilities for minor surgery, family planning and physiotherapy
- A spacious open-plan reception area and waiting room
- Disabled facilities, including a disabled toilet.
The Computer System
The practice has been computerised since 1992. Several upgrades have been necessary over the years and we now consider ourselves to be one of the more progressive practices in IT.
We have a high speed network of 40 PCs running Windows 7. As a result, all consulting rooms have word-processing, spreadsheet and database facilities and twin-bin laser printers. We also have full high-speed NHSNet access from the consulting room PCs, including email and access to the internet.
Our clinical software is EMIS with electronic appointments, pathology links, a clinical record based on Read-codes and including DXS and ScriptSwitch (a prescribing support system), full search and report facilities, and a clinical audit module.
All the partners use the computer system for recording clinical records and prescribing, and we have a summariser of medical records who enters important information into the patient’s computerised summary. As a result we have a fairly complete electronic medical record for most patients. We have been ‘paperless’ since 2006 with scanning of all in-coming documents and full access to these from within the computer record.
Partners’ Special Interests
Most GPs develop areas of special interest, to complement their basic GP work, and our GPs are no exception.
Julie Newsham and Louise Hopkins have interests in Family Planning, and together with our nursing team provide family planning appointments.
Julie has experience as an Ophthalmologist and does some minor ophthalmic surgery in the practice.
Jonathan Millar is the IT expert in the surgery, and also plays an active role in the development of NHS IT across Berkshire and nationally.
Jonathan has an interest in acupuncture, and having been trained by the British Medical Acupuncture Society, is able to offer some acupuncture services to our patients on the NHS (time permitting!).
Marc Batista has a specialist interest in sports medicine.
Sarah Haldane has a specialist interest in dermatology.
Javaria Akhter and Shirin Shakur both have a specialist interest in Diabetes management.
Appointments and out-of-hours
GP principals no longer have a contractual obligation to provide 24-hour care for their patients (this obligation ceased by the end of 2004, when GPs became able to ‘opt-out’ of out-of-hours care). However, experience of how GPs work out-of-hours is still a vital part of any GP Registrar’s training, and a Registrar will usually be expected to take some part in the local out-of-hours service, WestCall, sitting in with an experienced doctor in the Primary Care Centre or out on the road doing visits.
We have an on the day multidisciplinary team working within the practice made up of GPs, Advanced Nurse Practitioners, Paramedics and Pharmacists who all deal with patients as an on the day basis. We have 3 duty GPs (one of whom is lead) who see patients face to face for acute problems and have a shared telephone call list; we have a full time prescribing advanced nurse practitioner who sees patients on the day for minor illnesses such as coughs, colds, fevers, etc. Alongside this we have a full time paramedic from SCAS who visit our housebound patients to avoid hospital admissions and when they have any spare time, manage the care planning for housebound patients. Our Practice Pharmacists deal with medication queries and also deal with clinical letters and work with other staff members within the MDT. They see patients face to face for both medication reviews and management of chronic conditions.
We are currently working on recruiting physiotherapists and talking therapies to participate in the on the day team as the next phase of our pilot.
Any GP outside of this team would have pre-booked appointments of 15 minutes in length to manage continuity of care for patients. Both of the surgeries will operate on this system.
Once established in the practice, the Registrar takes a share of the on-call workload by being allocated to a different on-call doctor each week to do the emergency consultations and visits, while supervised by that doctor.
All members of the surgery are involved in the teaching of GP registrars and medical students. A programme of tutorials is arranged by the GP trainers, and the teaching is provided by the member of staff most appropriate to the topic.
The practice has video recording equipment for consultation analysis, and the Registrar is encouraged to participate in all practice matters, and to attend all meetings, both business and clinical.
We pride ourselves on being a very friendly practice. The doctors get together every day in the staff room to do their paperwork and have a coffee after morning surgery – an ideal opportunity to discuss problems and share experiences, and one which we all value greatly.
The partnership also provides two major social events each year: A summer barbecue (usually in ex-partner John Nash’s back garden, weather permitting) and a Christmas dinner/disco. All staff and their families are invited and invariably have a great time.