The light - Group practice
Charlotte Hudson, deputy editor of Practice Matters, interviews Nick Giles, area operations manager for the One Medical group - The Light, Leeds, about the secret to the practice's success.
What is the practice demographic?
The Light has a very young, working population; we
have very few elderly patients. This means that our GPs
don’t have to do many home visits, and most visits to
the surgery are for acute illness as opposed to chronic
illness. The male to female split is 50/50 and there are
a number of child patients. Patients don’t have to live
in the city centre to register with us, we have patients
who live in Bradford but work in Leeds so it’s easier for
them. We are open from 7am until 8pm on some days
so this suits a lot of people working in the city centre.
How many patients do you have?
We currently have 11,500 patients, and this is growing
by an average of 1,000 patients per year. We get an
influx of between 700 and 800 new patients when
students move into the area in August/September. We
promote the practice to new students by attending
the halls during move-in and handing out promotional
Since working at The Light I’ve done three
presentations, for the 9,000th patient, 10,000th patient
and 11,000th patient. We call them up, invite them into
the practice and invite the local paper down if they’re
happy to be photographed.
How long have you worked for the practice?
I’ve worked for the group since November 2012. I used
to work at Abbey Medical Group in York, and prior to
that I was the regional director for a number of food
retail companies. The NHS was all new to me when I
got the job in York.
Why the One Medical Group
I liked the idea of looking after numerous sites, being
able to share best practice, and also transferring my
years of experience to the NHS. I feel that the NHS has
not always been very business-focused, so I found the
job attractive because I can look at how we can be
more efficient and cost-effective.
The Light Surgery, run by the One Medical Group, is the first and only NHS GP surgery in Leeds city centre. Based in The Light Shopping Centre, it is situated in a prime location for local working professionals and students.
Nick Giles looks after six sites in total, which make up just part of the One Medical Group.
Tell me about your PPG…
We’ve had a PPG for about two years – it works well but it is
difficult to engage with patients. We have ten patients on the list
and hold quarterly meetings, usually with two or three different
patients each meeting.
The PPG has been instrumental in making a number of
improvements in the practice. We’ve had real problems with
women not coming in for their cervical smears, so we did a
survey and got the PPG involved, asking patients when the best
time would be for them to come in for their smears. We had two
results – lunchtime drop-ins and Saturday mornings. Saturdays
were very successful.
The PPG also helped with the Friends and Family Test – patients
can either fill in cards, give feedback via text, or use the iPad
that is on the reception desk, which we think is quite innovative.
The majority of patients say they would be extremely likely to
recommend us. Our response rate is currently 14%, which is an
achievement in itself, because most practices have an average
response rate of about 4%.
It is now a requirement for GP practices to provide online access for patients. How has The Light implemented this in the practice?
We have provided online access for two years. We have 1,800
patients signed up now, which is around 14% of the population.
This list is growing all the time. Patients can also download our
app from the website.
Have you developed a ‘safety culture’ in preparation for a CQC inspection?
Because we have a number of sites that have already had an
inspection, we have a good idea of what to expect. During the
inspections you basically have to be honest – talk about what’s
good, what’s bad and how you’re going to fix any problems. They
are very interested in hearing about how you’re going to resolve
issues. We have a very good safety culture in practice. We hold a
clinical meeting once a month, made up of all clinicians, and we
also have a lead GP and a group medical director who he reports
to. All significant event reports are submitted online, and once
submitted, they go into the minutes of the next clinical meeting,
are discussed and learning points made so it doesn’t happen again.
DNAs at the practice are at 4%, when they were
once at 15%. This has been helped by 91% of
patients giving us their phone details, which enables
us to contact them via phone-call and text message
– and for patients to reply by text message.
What are the challenges for the practice? How are you overcoming them?
We don’t have enough doctors, nurses or appointments.
Patients are more demanding now; they want more
access, they want it quickly, and they want what they
want and not what they necessarily need. To get around
this we try to be very efficient.
We are in the process of setting up a central hub, made up
of a bank of secretaries, note summarisers, read coders
and letter readers. This central hub of staff will handle all
work across all sites that make up the One Medical Group,
filling the gaps that occur when staff are absent, ensuring
the quality of service to patients. We are lucky because
it’s not something you could do unless you have got a
For example, if a doctor goes on holiday or phones in sick,
one of our doctors can log in to the system remotely
and do telephone appointments, sign prescriptions
electronically, do pathology, etc.
What do you like most about your job?
I like developing staff and seeing them improving what
they do. I also like communicating with people, sharing
best practice, and seeing results of where we have done
things differently. My role is a good mix of business and
looking after people.
What is the secret to your practice’s success?
In order to be successful you need to surround yourself
with good people that can do the job, create a nice
working environment for staff, and reward them properly.
Good communication is vital and getting staff to buy-in to
what you’re trying to achieve is important.
Be innovative – do something different that makes you
stand out from others. Offer patients what they want –
for example, our opening hours and drop-in sessions are
there as a result of feedback from patients