Abbeyview Surgery

A Message from Lord Pickles and Lord Blunkett, followed by Abbeyview Surgery's best practice article

The ability to listen and learn from one another has always been vital in parliament, in business and in most aspects of daily life. But at this particular moment in time, as national and global events continue to reiterate, it is uncommonly crucial that we forge new channels of communication and reinforce existing ones. The following article from Abbeyview Surgery is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

Blunkett signature Rt Hon The Lord David Blunkett
Pickles signature Rt Hon The Lord Eric Pickles

Dr Fleur England, Dr Abhijit
Banerjee and Mrs Helen Herbert
The Abbeyview Surgery
Abbeyview Surgery is a primary care surgery that serves
7,400 patients in rural Lincolnshire. Dr Fleur England
is one of their two GP partners; she, along with the
rest of the Abbeyview team, have worked in conjunction with
their Patient Participation Group to successfully create over 30
additional clinical hours a week. At a time when budget cuts
and recruitment concerns are plaguing the healthcare sector,
they have managed to efficiently increase access for local
patients and innovate to enhance the quality of their patient
care. Fleur tells
The Parliamentary Review
about how this has
been achieved and the surgery’s work with their PPG.
Our patient-focused team approach has enabled us to embrace change, improve
efficiency and achieve more with our current resources.
Driving innovation, without compromise
Our co-ordinated approach has enabled us to implement a sustainable way to
improve patient access, streamline services and maximise quality time for patients.
Our innovations include:
»Replacing a part-time GP with a full-time nurse practitioner, creating an
additional 50 appointments per week without compromising care quality
»A GP-led telephone call-back service, which has created an additional 75
appointments per week while offering choice and convenience
»GP Partners: Dr Abhijit
Banerjee and Dr Fleur England
»Business Manager: Mrs Helen
»Current structure established
in 2011
»Based in Crowland, Lincolnshire
»Services: Primary care medical
»No. of employees: 23
»Average length of servicing
staff is 11 years
»CQC: “Good” or “outstanding”
in every area, 2015
»First to achieve the Lincolnshire
Carers Quality Award in 2016
Abbeyview Surgery
Highlighting best practice
»A weekly GP-led minor illness walk-
in clinic with further
ad hoc
throughout the year, which bolster the
team’s ability to cope with fluctuations
in demand and staff absence
»Reviewing nursing workflow and
improving our use of computer
templates, concepts and protocols.
Streamlining data input has reduced
the time we take to accurately
record consultations while improving
quality and safety standards
»Utilising the appointment embargo
system and the care navigator
principal to direct patients to the
most appropriate professional, inside
or outside of the practice
»Improved communication with
patients through social media,
newsletters and web updates,
managed jointly with our PPG
»Upskilling clinical and non-clinical
staff, who now offer appointments
for minor illnesses and proactive
support for carers and dementia
patients, rather than GP appointments
»Training clinical staff in personal
productivity; unused appointments
are used to provide proactive
interventions and support, potentially
reducing future demand
»Customised telephone service and
online appointment booking
»Text reminders to reduce failed
Enhancing and improving
what we can offer
Creating this additional time has
enabled us to meet demand and to
enhance our existing offering, with the
introduction of multiple new services at
the practice.
The first of these is a nurse
practitioner-led weekly ward round at
local care homes, which has resulted
in a reduction of GP emergency visits
and hospital admissions. We have also
introduced targeted
ad hoc
clinics; these allow patients who work
through the week to attend for NHS
check-ups, flu vaccinations, smears or
annual preventive care reviews.
We now also use a surgery pod – leading
technology which maximises patient self-
service. Non-clinical staff signpost and
support patients to access the pod for
routine reviews such as blood pressure
and weight checks. Clinical results are
then safely entered by the patient,
without the need for an appointment,
and reviewed in a more efficient manner.
Diabetic and respiratory patients also
benefit from having their annual review
with the nurse; appointments with the
GP can then be reserved for patients
whose health is urgently deteriorating.
Any necessary interventions can
then be made immediately, without
necessitating a return visit.
Working with our PPG
Investing time to develop and maintain
an effective partnership with our PPG
has been a key factor of our success.
The PPG have supported the practice
with annual patient education and
support events, which provide patients
and carers with knowledge and
empower them to self-manage. They
also support our work with patient
communications and interact with local
media. Finally, they run patient surveys
and analyse the data collected. We
then review this with them and agree
an action plan.
The Abbeyview surgery
Our co-
approach has
enabled us to
implement a
way to improve
patient access,
services and
quality time
for patients
Managing expectations
One of the things that really drives us
is an ethos of putting the community
back at the centre of general practice;
this, unfortunately, goes against the
government ethos of creating a giant
organisation that’s strictly value for
money. We try to provide community-
relevant knowledge and insight while
still working within funding and
logistical constraints.
We have to work differently without
working more – efficiency is of
paramount importance. This frees up
more time for us to provide core services;
a lot of general practices are still on ten
or 15-minute standardised appointments
because that’s always been the way.
We’ve wiped the slate clean, allowing
us to now customise everything to each
individual. It’s about working smart
just as much as it is working hard –
processes have to be intuitive.
A constantly fluctuating
We’ve always operated without any
major funding. The work we’ve done
as a surgery, we’ve done on our own
– and we believe that our team makes
the difference. Core funding is often
provided by the NHS based on statistics
and figures; in a community like ours,
we can’t afford to tick boxes. This
won’t satisfy our patients – meaning
that we have to make the money we
do have go further.
Working with our PPG is not always
seamless, either. They’re such an
invaluable asset for our operations,
but their understanding of the NHS
is not the same as ours. They’re also
not directly employed by the practice,
meaning that many often come and
go. They bring a massive amount
of community-led support into the
surgery and provide us with real insight
into what our patients need, but they
are a group that’s constantly changing;
that comes with its own challenges.
A model for success
In conjunction with our PPG, we
reviewed our dementia services while
involving training staff and members
of the local community. Everyone
who was a part of this then became
“Dementia Friends” and hosted
an educational event to provide
community dementia awareness
education. We are the first practice
in the county to have undertaken
this kind of project, and we hope to
engage with similar initiatives going
As a member of Allied Health Services
GP Federation, we now include a
care co-ordinator in our team, who
supports more vulnerable patients
who have multiple co-morbidities.
This connects us to our local
neighbourhood team, improving
sustainability for the NHS and social
care – it grounds us within our
community ever further, which is
something we’re always looking to do.
Our committed, person-centred and
community-led approach to supporting
both carers and patients is now being
replicated across Lincolnshire. We look
earnestly to a future where this kind of
service is offered on a wider scale.
One of the
things that really
drives us is an
ethos of putting
the community
back at the
centre of general
The nursing team

This article was sponsored by Abbeyview Surgery. The Parliamentary Review is wholly funded by the representatives who write for it. The publication in which this article originally appeared contained the following foreword from The Rt Hon Theresa May MP.

The Rt Hon Theresa May MP's Foreword For The Parliamentary Review

By The Rt Hon Theresa May MP

This foreword from the then Prime Minister appeared in the 2018/19 Parliamentary Review.

British politics provides ample material for analysis in the pages of The Parliamentary Review. For Her Majesty’s Government, our task in the year ahead is clear: to achieve the best Brexit deal for Britain and to carry on our work to build a more prosperous and united country – one that truly works for everyone. 

The right Brexit deal will not be sufficient on its own to secure a more prosperous future for Britain. We also need to ensure that our economy is ready for what tomorrow will bring. Our Modern Industrial Strategy is our plan to do that. It means Government stepping up to secure the foundations of our productivity: providing an education system that delivers the skills our economy needs, improving school standards and transforming technical education; delivering infrastructure for growth; ensuring people have the homes they need in the places they want to live. It is all about taking action for the long-term that will pay dividends in the future.

But it also goes beyond that. Government, the private sector and academia working together as strategic partners achieve far more than we could separately. That is why we have set an ambitious goal of lifting UK public and private research and development investment to 2.4 per cent of GDP by 2027. It is why we are developing four Grand Challenges, the big drivers of social and economic change in the world today: harnessing artificial intelligence and the data revolution; leading in changes to the future of mobility; meeting the challenges of our ageing society; and driving ahead the revolution in clean growth. By focusing our efforts on making the most of these areas of enormous potential, we can develop new exports, grow new industries and create more good jobs in every part of our country.

Years of hard work and sacrifice from the British people have got our deficit down by over three quarters. We are building on this success by taking a balanced approach to public spending. We are continuing to deal with our debts, so that our economy can remain strong and we can protect people’s jobs, and at the same time we are investing in vital public services, like our NHS. We have set out plans to increase NHS funding annually by an average by 3.4 percent in real terms: that is £394 million a week more. In return, the NHS will produce a ten-year plan, led by doctors and nurses, to eliminate waste and improve patient care.

I believe that Britain can look to the future with confidence. We are leaving the EU and setting a new course for prosperity as a global trading nation. We have a Modern Industrial Strategy that is strengthening the foundations of our economy and helping us to seize the opportunities of the future. We are investing in the public services we all rely on and helping them to grow and improve. Building on our country’s great strengths – our world-class universities and researchers, our excellent services sector, our cutting edge manufacturers, our vibrant creative industries, our dedicated public servants – we can look towards a new decade that is ripe with possibility. The government I lead is doing all it can to make that brighter future a reality for everyone in our country. 

British politics provides ample material for analysis in the pages of The Parliamentary Review 
The Rt Hon Theresa May MP
Prime Minister