FIRST, the bad news. Over the next seven years, the Central Dales GP Practice, on which more than 4,500 of us depend for our health care, will lose £74,000 thanks to complex changes to government funding for family doctors. When the seven years is up, the practice will have to manage its surgeries in Hawes and Aysgarth on between £25,000 and £31,000 a year less than they do now.
Meanwhile, Upper Dales Health Watch, which keeps an eye on such matters for us, the tax-paying public, reports that there is no extra money in the NHS to support deeply rural practices like this one. In other words we are on our own, with an ageing population (nearly a third of the patients in the practice are over 65) with increasingly complex needs, public transport cut to the bone, and a looming crisis, nationwide, in health and social care provision.
Now the good news: Lynn Irwin, new practice manager at Hawes and Aysgarth surgeries.
Thirty-one years old, confident, optimistic and outgoing, and certainly not on her own: with the team of four GPs in the practice, she is determined that both surgeries will survive and thrive and that services will improve.
She is not just cautiously optimistic but visibly excited at the prospect of finding ways to do more with less. There is nothing to suggest that Lynn, appointed last December and about to go full-time because of the demands of the job, is either in denial about those problems, or putting a gloss on a situation that is potentially dire.
“General practice has entered a new era and we’re on the brink of a lot of changes in the way we care for people. It is a real challenge but it’s why I’m so excited about it,” she says.
Those changes have started already. With others, she has been instrumental in forming the Heartbeat Alliance, a federation of all GP practices, except Reeth, within the Hambleton, Richmondshire and Whitby Clinical Commissioning Group.
Together the 21 practices can bid to provide additional services (bringing more income), retain the ones currently under threat such as coil fitting and minor surgery (keeping income that might otherwise be lost), and generally bringing care closer to home, a major bonus for rural communities 30 miles from the nearest hospital.
Already the federation has won a grant from the Prime Minister’s fund of £2.4 million to make community services far more integrated.
“For example, we could employ more district nurses, some to work closer with the over-75s.
Care homes are having to admit older people who wouldn’t need to be admitted if they had more general practice care. That can bring huge savings and help more people to stay in their own homes.”
But for now there are problems on the ground to sort out: notably the much-prized openaccess surgeries at Hawes and Aysgarth which rumour has it are about to disappear.
Says Lynn: “They’re not. But they are getting full of patients wanting medication reviews or non-urgent treatment. We are trying to encourage people to use the morning walk-in surgery for when they’re really poorly or need urgent attention and then make appointments for the afternoon or evening.”
As you mention appointments, as someone did at a recent parish council meeting, there’s uproar. “If you get appointments we’ll be waiting two weeks to see a doctor, like people in the cities,” said one aggrieved resident.
Lynn’s response is typically direct: “No you won’t. I could take eight more appointments this very afternoon and, look, I would still have room for six emergencies. The morning surgeries are getting busier, going on until one o’clock some days and leaving the GPs little time for home visits before afternoon surgery.”
They are also keen to encourage people to sign on DARLINGTON & STOCKTON TIMES WEEKEND dst.co.uk FRIDAY, AUGUST 22, 2014 37 with the practice as soon as they move into the area, not wait until they are ill: more patients mean more cash.
Originally from Darlington, Lynn left school after GCSEs because she didn’t want to waste time “sitting around in lectures and end up with a mountain of debt”, became apprenticed to a legal firm, passed all her exams on the job, married a gamekeeper, Marcus, had a baby, became a conveyancer for a Hawes legal firm, got fed up with housebuying wrangles and found a new challenge as manager of the Harewood practice in Catterick for four years before coming to Hawes.
Amid all this, she’s just completed an Open University degree in business management and leadership, but she’s not having a graduation ceremony.
“It’s not my thing. I wanted the degree for practical purposes, and I haven’t time to be organising a big celebration. I just want to get on with the job,” she says brightly.
There’s a lot to do: more training and support for the staff, a vastly improved online system allowing patients to book appointments and re-order drugs, barcode scanning for prescriptions to eliminate error and improve stock-keeping, and better waiting-room facilities to allow greater privacy. This includes Radio 2 on the sound system.
“Well, we tried introducing soothing classical music, thinking it would be nice and relaxing if people were a bit stressed. We had so many complaints you wouldn’t believe it! You can’t please everybody, can you?”
No, but you get the sense that at least they’re trying.
- Patients can meet Dr Adrian Jones and Lynn Irwin over a cup of tea on Monday, September 22, at the Yorebridge Community and Sports Centre in Askrigg between 6.30pm and 8.30pm.