The Orchard Medical Centre

About the practice

Orchard Medical Centre is at home in a large, purpose-built surgery owned by the partners. The medical centre houses all of the practice team as well as the district nurses and community matron.

Other services use the facilities regularly and the practice is keen to work closely with and get to know providers who are delivering services to patients. There is room to expand and use the space even more effectively.

The practice has worked hard to develop a strong sense of teamwork and engagement. It’s a true team effort, and the practice has engaged with more great people over the last year.

Orchard Medical Centre continues to build links with local practices, learning to work together more closely and is actively involved in the locality group. The team are committed to participating in new initiatives to help relieve the pressure in Primary Care.

The practice regularly explores digital solutions which can support the team and our patients.

Most recent projects include the development of new interactive website and a personalised text messaging service, which are both nearly ready to go live. Staff actively encourage patient continuity for those that really need it and work to create this both in terms of appointments as well as any paperwork and admin.

The team are in the process of developing their PPG and hope to see more patient engagement over the coming months.

Working environment, values and culture

Orchard Medical Centre is home to a friendly, organised team that strives to deliver high-quality care by adapting to the budget pressures and adopting new ways of working. This innovative practice is always looking for practical solutions to improve efficiency and sustainability.

The team strives to be the best that it can be.

As a whole practice, the team has fully embraced Healthcare Navigation, supporting them to work smarter not harder to manage increasing workload and get the whole team working for the benefit of the patient. Communication is enabled by regular clinical meetings and daily coffee breaks, involving everyone in decision-making and clinical leads are responsible for specific areas of work.

This allows us to provide 15-minute appointments and we have no Duty GP system, reduced home visiting and a good work life balance.

The practice has left behind an unmanageable GP on call system and now works generally in 5-hour shifts where 4.5-hourss of work is rota and the final 30 minutes is left flexible. The maximum day is now 9-hours and patients are no longer seenbeyond 6.30pm. Those working until 6.30pm don’t start until 9.30am, and those starting at 8am are free from 5pm.

We consider 8 sessions a week as full-time.. Each GP may have 1 visit per day which is done alongside admin in a 2-hour gap in the middle of the day. There are 15-minute appointments for all routine work and some same day reserved appointments which are 10-minutes. These are often not filled allowing for a bit of extra catch up time.

Workflow optimisation enables the admin team to manage all results and letters, taking out all the work that they can and only passing on to the GPs what is necessary. A skilled script team is led by the clinical pharmacist and they manage most script queries. Nurse prescribers and reception deal with a lot of the more straightforward things like UTIs.

Healthcare navigators actively monitor appointments and, if someone is struggling during clinical sessions, will try and manage workload and move patients around to keep the day on track.

GPs work on a 1 in 10 Saturday morning shift with time released back in the week for this. There are opportunities for weekend and evening work and we are working with local practices to develop this.

Orchard has carer support workers, engages with local prescribing teams, drug and alcohol workers and has a number of NHS clinics run by outside organisations such as the outside clinic, GP Care and others.

The team links with Age UK and social prescribing teams along with social services and the community teams in weekly MDT meetings. Team members have specialist interests care of the elderly, nursing homes, cardiology services, minor surgery, appraisal work, IT optimisation, drugs and alcohol work and working with Asylum seekers. So it’s never dull and there is plenty of flexibility!

There is a lot of scope to develop interests alongside commitments to patients.

What we offer

The practice offers an organised induction package for new starters during the first two weeks, which helps getting to know how we function as a practice and meeting the team.

The practice wants people to feel properly connected with where they work and to settle in as quickly as possible. GPs meet for daily coffee to catch up as well as regular clinical and non-clinical meetings.

Staff are encouraged to use the comfortable staff room for lunch and breaks.

The Christmas Party and the Summer Barbeque are regular whole team social events, as well as ad hoc gatherings throughout the year.

Team members are supported whatever their personal circumstances and to be the best that they can be too.

Benefits vary and will be discussed upon appointment. Standard benefits include the childcare voucher scheme, annual leave, maternity leave and flexible working arrangements where possible.

Learning and development

The Orchard is a training practice with two trainers and usually two trainees at any one time. Medical students are shared with salaried GPs who have an interest, as well as partners. Clinical leadership supports the nursing team, pharmacist and new GPs as they start their career once leaving the support of the Deanery. GPs are encouraged to explore and take up extended roles if they want to. Study leave and financial support is offered for courses. The practice engages in local CCG learning events, freeing up time in turn so all GPs get exposure to this, along with fortnightly clinical meetings.

The practice also additionally organises things like resus training in house and offers protected time to ensure everyone gets the time to prepare and attend annual appraisal.

Our patients

South Gloucestershire is one of the fastest growing areas in the South West, with major housing and employment developments planned. South Gloucestershire is not a deprived area, but there are some pockets of persistent relative deprivation. Inequalities are mainly in health & wellbeing, educational attainment, and employability.

The Orchard team are keen to improve the service for patients and are working on a number of developments that they know have been problematic in the past, such as telephone and appointment access. This is starting to have effect and generating positive feedback from patients.