Bewick Road Surgery

Highlighting best practice as a representative in The Parliamentary Review

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 Bewick Road Surgery is an attempt to do just that. We would welcome your thoughts on this or any other Parliamentary Review article.

GP Dr Ruth Bonnington
Some of the Bewick
Road Surgery team
Founded 100 years ago, Bewick Road Surgery is a general
practice that serves 6,500 people from the local community
with many patients from families that have lived in
Gateshead for generations. It also serves a large local Jewish
community, as it is based close to some of the most prestigious
religious academic institutions in the world. As a result, many
patients have moved to the area from within the UK, Europe,
Israel and the Americas to study or settle. Dr Ruth Bonnington
discusses the keys to success within the industry.
All our doctors work part time as several have young families and other roles in
their portfolios. The practice is always busy and I usually suggest that the medical
students spend some time with the receptionists so they can understand how they
bring order out of chaos, endeavouring to get each patient the right care with the
right clinician and in the right timescale. General practice is never dull and, while it
is hard work, it is incredibly rewarding.
We are a teaching and training practice and students from Newcastle University
join us for placements in each of the five years of their degree. We have GP
registrars placed with us, usually for six months at a time. Some come with
experience and are about to become fully fledged GPs, while others have never
been in general practice. Each training registrar has different skills, experience
and personality, so we aim to be as flexible as possible to ensure the training we
provide is appropriately matched to their requirements.
»Dr Ruth Bonnington is one of 5
GPs at the practice
»Dr Ruth has been a GP in the
practice for 25 years
»Based inGateshead, Tyne and
»Services:General practice
»No. of employees: 18
Bewick Road Surgery
Highlighting best practice
Change and adaptation
Clinically there are evidence-
based changes in guidelines for
the management or treatment of
conditions – so there is always learning
to be done. Implementing learning
can mean we need to adjust what we
do as individuals and then share this
knowledge with each other, while
also changing or setting up systems to
support the correct care of patients.
The way the practice receives money for
the services we provide also changes,
resulting in adaptations to our provision
and how we refer patients to secondary
care, social care and the third sector.
A significant amount of what we do is
measured and all these external systems
are driven by the desire to improve care,
ensure the service is as comprehensive
as possible and that populations and
individuals are cared for and protected.
The computer systems and the collation
of data across the UK is an incredible
intelligence and can enable practices to
understand areas for development and
hopefully best practice to be shared to
drive upstandards.
Most practices are now part of primary
care networks. This was a central
initiative to improve resilience in
primary care. Like any collaboration
there are multiple benefits, but it
requires significant investment of time
to make this effective. Time is always a
challenge in stretched services. Making
decisions across a number of practices,
clinicians and managers can also
The Covid-19 vaccination programme
has consolidated our collaboration as
a PCN. It has required enormous effort
and determination to put the stringent
protocols and complex logistics in
place to make this happen. The council
and CCG have helped to locate the
building, parking and signage. Our
PCN team and practice teams have
been incredible, both on and off the
vaccination site, to make sure that the
most vulnerable are able to get this
vital protection.
It has been a privilege to be a part
of this venture. Many will continue
to work over and above their normal
hours to deliver the full programme in
the coming weeks.
The local Jewish community is very
proactive when it comes to health. We
work closely with their advocates and
chaplain and are immensely impressed
by their volunteer ambulance service
and communication hub. We
endeavour to work with public health,
secondary care, mental health services,
the council and the third sector to
maximise health at an individual and
community level.
Development and training
We always try to ensure that we
develop staff and engage in teaching
and training. This learning environment
brings energy to the practice but also
challenges as we try to find time do so.
Space is also restrictive as our building
is less than half the advised size for a
training practice of our size. However,
it brings the opportunity to ensure
there will be a sufficient workforce,
locally and nationally, into the future.
Student training and
We are a
teaching and
practice and
students from
University join
us for
placements in
each of the
five years of
their degree
Our current manager started as an
apprentice with us at the age of 16.
Despite every effort, occasionally
errors occur, care is not as good
as we would aim for and there are
complaints. However, every incident is
an opportunity to improve a system,
communication or skills or to correct
a misunderstanding. We therefore
have a low threshold for investigating
potential problems. In doing this we
aim to improve our systems, train our
staff, maintain our relationship with
patients and provide high quality care.
Working out of hours
I have worked almost exactly the
same rota for the last 25 years in
what used to be a GP out-of-hours
cooperative. Out of hours is a fantastic
learning ground for medical students,
GP registrars and me as it provides
a different context and leads to the
higher likelihood of dealing with more
acutely ill patients.
Working out of hours helps us to
understand the impact of in-hours
patient care and records. Such work
has influenced our record-keeping and
sharing of emergency health care plans
with out-of-hours health providers.
Our stressful journey to move to
suitable accommodation started 14
years ago, and the huge challenge to
find premises that are appropriate for
our needs continues. Eight years ago,
a local NHS organisation approached
us to collaborate on an alteration to
an unused council building. The plans
went to NHS governing authorities
for mandatory approval. This took
four years, by which time the other
organisation had no requirement or
funds for the project. The council looked
at developing the accommodation for
us but found it financially unviable
Now we are progressing a proposal
for a private investor to work with
us and the council to develop the
property. We are excited that this will
create a great health hub in our local
community with truly fit-for-purpose
accommodation. However, we are
very conscious that we need the NHS
organisations and authorities and
council and investor to collaborate, and
to have a strategic and long-term view,
in order for this to come to fruition.
Facing unprecedented
Covid-19 has of course had a substantial
impact on our practice. We are as busy
as ever providing care and switched to
total triage early on and spent many
hours updating ourselves on clinical
information and guidelines. Significant
numbers of patients have had
Covid-19 in different ways including
hospital admissions and sadly deaths,
in care homes as well ashospital.
As we manage winter, ongoing
waves of infection, and the impact
of test and trace and infections on
staff numbers, the challenge is how
to protect the services we provide for
patients while delivering the vaccine.
We need to be conscientious in being
Covid-secure, flexible in the way we
all work and ready to support each
other in the practice and potentially in
neighbouring practices too.
The Covid-19
as a PCN
Hatzola, the volunteer
ambulance service

This article was sponsored by Bewick Road Surgery. The Parliamentary Review is wholly funded by the representatives who write for it.