You're thinking of merging your practice with another one down the road
- you need to think about public consultation, moving staff, telling the
patients, maybe even developing new premises, and on top of all that, there
are patients records to consider.
Two practices in Nottingham found themselves in this situation over the summer.
How did they manage the merger and how did SystmOne help ease the strain?
Church Walk Surgery and Park View Surgery were situated a third of a mile
apart in the Eastwood area of Nottingham. This year, they decided to become
one bigger practice with 33 staff serving just under 12,000 patients. The
two practices had worked together for a number of years, sharing a Saturday
morning rota, covering for each other in emergencies and running a joint
phlebotomy service.
Alison Rounce was the Practice Manager at Church Walk before the move and
is now a managing partner. She says, "As a small practice with under 3,000
patients, Park View Surgery had practical problems with things like covering
holidays. We felt that by combining the two sites, we could offer a better
service to our patients. Church Walk had a full-time Nurse Practitioner and
skills in things like acupuncture that Park View was unable to resource,
while Park View had a Practice Nurse with diabetic training to initiate insulin.
As one larger site, we would have more flexibility to combine skills and
offer a far more comprehensive range of services, which is a great benefit
to patients."
Alison explains the merger process: "We had to go through a 30-day public
consultation, write to patients, advertise our intentions in the press and
hold two public meetings. The final decision was left to Nottinghamshire
County tPCT, who approved the merger on 19th July. We'd been upgrading the
clinical rooms at Church Walk since May so we were ready to move and we merged
into one practice on 1st August."
As both Church Walk and Park View Surgery used SystmOne, the merging of their
patient records was a simple task. Rajdeep Shergill, TPP's Business Process
Manager explains: "If one practice had been on a different system, they would
have needed to undergo a full data migration to SystmOne, but because both
were already on the system, all their patient records were held on the SystmOne
central server and so the merge was straightforward. The majority of the
work is done by TPP in the background, so the burden on the practice was
minimal."
Before two practices can merge, there is some work that needs to be done,
but with forward planning, this needn't be a problem. Alison says, "When
Raj came to explain the process to us, she said that it was far less onerous
on the practice than preparation for a Go Live. I'll admit that I was sceptical
at first but she was right. We had to convert Park View's appointments on
the merge day, do some prior work to reconfigure their Smartcards, and make
preparatory lists to make sure the disease registers tallied, but the merge
itself was an overnight process. I left at five o'clock on the Wednesday
night and when I came in on the Thursday, it was all done."
The merged practice, Church Walk Surgery, is now part of a PBC cluster of
13 practices (five of which use SystmOne) covering 97,000 patients. They
are working with the cluster to provide Practice-based Commissioning services. "One
of the deciding factors for the merger was Practice-based Commissioning," says
Alison. "Merging with another team of clinicians gives us scope to diversify
clinical expertise. For example, one GP has a special interest in COPD and
so we now employ two COPD nurses in primary care on behalf of eight of the
practices in our cluster."
Now successfully operating as one practice, Church Walk is able to work in
new and innovative ways, offering previously unavailable services. Alison
has this to say to other practices thinking of merging: "With a bit of planning,
the merge will go smoothly - it doesn't need to be complicated. It really
is much less demanding than a Go Live, and we received all the support we
needed from TPP."
Alison has been working in general practice for 13 years and has seen it
change over that time, working as a fund-holding practice, moving to a centralised
system, and now merging with another practice and being involved in Practice-based
Commissioning, but what does she see as the biggest change? "I think the
biggest change in primary care was the introduction of QOF," says Alison. "It
was so far-reaching with regard to changing the way we manage disease registers
and the way administration is undertaken. It adds structure and process to
what we're doing for our patients. SystmOne absolutely helps us with QOF
- we use 'How am I driving' as the basis for day-to-day work with regard
to where we are in the year and as a basis for sending for patients on the
registers."
Now that Church Walk and Park View have merged and are moving forward with
new services, what do they see for the future? "Since we merged, we've introduced
the Patient Self-Arrivals with a touch screen in the waiting room and are
in the process of encouraging patients to be confident enough to use it.
We're interested in increasing our efficiency and expanding choice for patients
in other ways now - we'd like to use the Adastra Out of Hours messaging,
the automated telephone booking service, and internet booking."
