Introduction 2

The Partners 3

The Vacancy 6

History of the Practice 7

The Town and its Surroundings 9

The Practice Team 11

The Practice Premises 14

Practice Organisation 15

Nuffield House Users Group 18

Information Technology 19

This document has been produced to describe in some detail our Practice at Nuffield House; it’s setting in the local and wider community, its personnel, the Town and various local facilities.

We are acutely aware that recruitment to general practice is difficult at present, because of increasing workload, resource problems, the changing aspirations of potential recruits to the speciality and the continuing problems of the NHS.

Although we face the same problems as any other practice, we are enthusiastic about the future of primary care within a modernised NHS.

In some ways, the Practice is very traditional with its firm belief in the long-established values of family medicine, personal lists, continuity of care and support for the right of patients to expect high quality medical care.

In other ways, the Practice is innovative having been a pioneer of the health centre, the Primary Health Care Team, the Patients Participation Group, medical computing, Health Promotion activities and the development of an extended role for the Practice Nurse.

Members of the Practice have always believed in playing a major role in the local management of health care, medical education and medical politics. Over the years, partners have served on Health Authorities, BMA committees, PCG/PCT boards, on the Local Medical Committee, as an examiner for the RCGP and as a GP Postgraduate Education tutor.

The whole Practice works together as a mutually supportive team, respecting each other’s skills and needs, and enabling each member of the team to develop interests and activities to the full.

We are looking for a new partner to replace Dr Shaun Firth, who is retiring and Dr Susan Hull, who is leaving the Town to support her partner in his new professional appointment.

The work is hard, the rewards are higher than average and the team gets on with each other better than most.

M.B.,B.S. (London), D.R.C.O.G. St Thomas’s Hospital

Qualified 1967

Trained at St Thomas’ Hospital Medical School and after qualifying did pre-registration jobs at the then newly-opened Princess Alexandra Hospital, Harlow before spending a year in obstetrics at Doncaster Royal Infirmary. Joined the Practice in January 1970.

Married with three children (Katherine, Edward and Alison) and a granddaughter, Rebecca. His wife, Penny, is involved in various local organisations, including the local Magistrates Bench.

Medical activities during the years have included membership of the West Essex Maternity Liaison Committee and of both the FHSA and North Essex Health Authority. Has been a member of the North Essex LMC since 1996 and a member of the General Practitioners Committee of the BMA since 1998. Since January 2000, has been working part time in the Practice and part time as a Professional Adviser to the NHS Ombudsman.

Non-medical activities have included Chairmanship of the Harlow Council for Voluntary Service, 14 years service as an elected member of Harlow District Council and current Chairmanship of the West Essex Alcohol and Drugs Advisory Service.

M.B., Ch.B. Makere University

Qualified 1968

Worked in various posts in Kenya and then as a medical registrar in local hospitals. Joined the Practice in 1976.

GP Trainer from 1988-1992. Currently on Harlow PCT Executive Committee. Set up the out-of-hours GP Co-operative in Harlow (which has now been replaced by Healthcall) and served as Medical Director throughout its existence.

Married with two children, Vineet, who has now finished university and is hoping to go into business administration and Shayal, who is in Coventry working in industrial design. His wife, Farakh, is a doctor who worked as an obstetric registrar at the local hospital, then went on the local vocational training scheme and is now working in sexual health.

Other activities: board member of Harlow PCT, Clinical Governance and Primary Care Tutor. Lead partner for the practice on New GMS Contract.

Non-medical interests: golf, gardening, carpentry, DIY.

M.B.,B.S. (London) Guy’s Hospital

Qualified 1978

Joined the Practice in 1981 after two years with the local vocational training scheme.

Married with two children, David and Michael. Her husband, Clive, has lived in Harlow for most of his life and is in partnership as a Veterinary Surgeon nearby in Epping.

Other activities: Works in the Department of Sexual Health and as Medical Adviser to Harlow Council housing Department.

Non-medical interests: family life and general demands, walking two demanding dogs, running and cycling.

B.Sc.(Hons), M.B.,B.S., D.C.H., D.R.O.G., F.R.C.G.P. Guy’s Hospital Qualified 1982

Joined the Practice in 1986 having completed the Plymouth Vocational Training Scheme. Pre-registration jobs at Guy’s and Derriford Hospital, Plymouth.

GP Trainer and Examiner for Royal College of General Practitioners.

Married to Carolyn, who is also a local GP. Two children, Matthew and Adam.

Other medical activities: Examiner for the Royal College of General Practitioners, Honorary Secretary of Essex Faculty Board RCGP, and GP Appraiser for Harlow PCT. Lead partner for the practice on Nuffield House Redevelopment.

Non-medical interests: soccer, golf, walking, reading and music.

B.Sc., M.B.,Ch.B. D.C.H. Manchester

Qualified 1989

Joined the Practice in 1989 as a job-share partner with Dr Swainsbury having been a trainee at Nuffield House. Now no longer job-sharing but working three-quarter time. Hospital experience was largely in paediatric jobs in Manchester and London.

Married to Alastair, a senior teacher at a Mark Hall comprehensive school in Harlow. Three children, Helen, Katherine and Gordon.

Non-medical interests: looking after the children, gardening and music.

M.B.,Ch.B.,D.R.C.O.G. M.R.C.G.P. Manchester

Qualified 1989

Joined the Practice in 1994. Pre-registration jobs at Blackburn Royal Infirmary and North Manchester General Hospital. Joined the Dartford and Gravesham VTS from 1991-1994, following which spent one year as an SHO in community paediatrics. Now an approved GP Trainer.

Married to Dr Anjila Agarwal, a general practitioner in Chelmsford. Most of his spare time is spent looking after two sons, however he tries to maintain an interest in computing and the Internet.

M.B.B.S., D.R.C.O.G., M.R.C.G.P., D.F.F.P.

Charing Cross & Westminster Medical School

Qualified 1993

After medical jobs in Kent, Bedford and Oxford, she joined the West Essex VTS in 1996, completing her Registrar year at Nuffield house. She joined the Practice as a part time partner in August 1999 and now works on a three-quarter time basis.

She also works as a Clinical assistant for one session a week at the Department of Sexual health and from time to time at the local Family Planning Clinics. Now an approved GP Trainer.

Her partner Mark is a medically qualified barrister, and they have a daughter, Emily.

The Partners at Nuffield House believe in the concept of personal lists and it is our intention to maintain Dr Firth’s and Dr. Hull’s list of patients for the new Partners.

The current vacancy in the Practice has been created by the resignation of Dr Shaun Firth, who is retiring from Nuffield House, and Dr. Susan Hull, who is moving away to be with her partner, Mark, after a job relocation to Manchester.

Dr Firth has a half-time contract with the Health Authority, and Dr Hull has a three-quarter time contract with the Health Authority. We are seeking to replace with one and half-time WTE GPs. We can be flexible for the right people, and consider full-time, part-time, job share and salaried options.

The Practice is moving towards the New GMS Contract for April 2004.

The Practice believes in the principles of equality of opportunity and all applicants will be carefully considered. The Practice has no preconceived requirements with respect to age, sex, race, marital status or sexual orientation.

The Practice operates to a partnership agreement, which was prepared by a solicitor according to the BMA guidelines and will be available for applicants selected for interview.

The Partners share the workload of the Practice in accordance with their contractual commitment and Practice profits are divided in the same way.

The principle of equity of workload is taken very seriously and duties and surgeries are arranged in accordance with this approach.

The new Partners would achieve immediate parity and have a probationary period. Since the Practice premises are rented from a charitable trust, the new Partners would not be expected to purchase a share of the property.

The Practice was founded in 1951 by Dr Charles Taylor who came to work with the late Dr Norman Booth in Old Harlow, which was one of the original villages now incorporated into modern Harlow.

The 1946 New Towns Act led to the development of Harlow as one of the post-war New Towns. In April 1951, Dr Taylor left Dr Booth’s Practice to establish the first General Practice in the developing new town. The Practice was established first in temporary accommodation in a former lodge house in Stackfield until the conversion of two adjacent semi-detached houses in The Chantry was completed. These original Practice premises were known as "Haygarth House". The original surgery notice board from Haygarth House is on display in the present premises.

Once established, Dr Taylor began negotiations with various bodies to obtain support for the development of what was at that time the novel concept of the Primary Care Team and began the task of designing a purpose-built health centre.

As the list grew, Dr Taylor was soon joined by Dr John Huntley and subsequently by Dr Sandy Findlater and Dr Erica Higgens. The Practice moved to the present premises in The Stow in 1955. This Health Centre, the first in the Town, was financed by the Nuffield Provincial Hospitals Trust and was opened by Lord Nuffield and named "Nuffield House".

The partners in the Practice since its formation have been as follows:

Dr Charles Taylor 1951 - 1986

The following doctors have been trainees/GP Registrars with our Practice:

Dr Elizabeth Ingham July 1987 - April 1988

Dr Alka Cashyap May 1988 - April 1989

Dr Tracey Clemans August 1989 - July 1990

Dr A Stanislaus August 1990 - July 1991

Dr Surrender Brar August 1991 - July 1992

Dr Geeta Patel August 1992 - July 1993

Dr Matthew Stokes August 1993 - July 1994

Dr Nda Abaniwo August 1994 - July 1995

Dr Helen Devonald August 1995 - July 1996

Dr Karsten Krumpolt August 1996 - July 1997

Dr Margaret Kisenyi August 1997 - July 1998

Dr Susan Hull August 1998 - July 1999

Dr Cristina Bruce August 1999 - July 2000

Dr Austin Oraka August 2000 - February 2001

Dr Ali Esteki November 2002 - April 2003

Before the end of the war, plans were drawn for the redevelopment of London and the dispersal of people and industry to several new towns beyond the metropolitan green belt. Harlow was one of the first sites chosen and the first residents moved into homes built in and around the original villages in 1949. There then followed the development of the first major area of the new town at The Stow, where our Practice premises are situated.

The town was built to a master plan by Sir Frederick Gibberd on a system of self-contained neighbourhoods, each with their own shopping centre and community facilities (including a health centre). The neighbourhoods themselves are separated by wide areas of green space and are clustered around the main shopping area known as The High.

Harlow is situated in West Essex on its border with Hertfordshire. It lies about 25 miles from both London and Cambridge and 7 miles from Epping, Hertford and Bishop’s Stortford.

Road communications are excellent with junction 7 of the M11 just south of the Town and the A414 providing a link to Chelmsford and the rest of Essex to the east and to Hertford and St Alban’s to the west. The junction between the M11 and the M25 lies 4 miles south of the Town and the M11 joins the A14 north of Cambridge, providing a good route to the North and the Midlands.

Harlow is on the main Cambridge to Liverpool Street railway line and there are fast, frequent services from the main local railway station, Harlow Town. There is also access to the Central line of the London Underground at Epping.

Stansted Airport lies about 10 miles to the north of the Town, just beyond Bishop’s Stortford and access to the airport is easy by road, train and bus.

It is sometimes difficult to overcome the misconceptions that many people have about the new towns. It is perhaps true to claim that Harlow is one of the most successful of the post-war generation of new towns. It was built to a very open plan around several existing village communities. Green spaces and old buildings have been preserved.

The local community is very active with a good range of recreational and sporting facilities, including a sports centre and a swimming pool. There are many local organisations covering a wide range of interests and the Harlow Playhouse provides an excellent venue for plays and concerts.

The District General Hospital for West Essex and East Hertfordshire, Princess Alexandra Hospital, is situated in Harlow. All local GP practices work from purpose-built premises and are part of the Harlow Primary Care Trust. Prior to April 2002, North Essex Health Authority managed health care in Harlow. From April 2002, the Town will be within the area of responsibility of the Essex Strategic Health Authority.

Our nearest teaching Hospitals are Addenbrooke’s to the north in Cambridge and The Royal London to the south in East London.

Private medical care is provided at The Thomas Rivers Hospital near Sawbridgeworth and at Welby House in Old Harlow.

Education in Harlow is provided through neighbourhood Primary Schools and 11-16 age group Comprehensive Schools. Post-16 education is provided at Harlow College. Private education is provided within the Town at St Nicholas’s School and nearby at, for example, Bishop’s Stortford College.

The effectiveness of any practice depends not only on the professional skills of its doctors but also on its whole practice team. We have always been fortunate at Nuffield House to enjoy a high level of competence and loyalty from our practice staff, most of who have been with us for many years. The present team comprises the following members:

Responsible to the Partners for the overall management of the Practice and line manager for all the directly employed staff at Nuffield House. Responsible for the financial affairs of the Practice and staff employment and training.

MRS ELAINE MURR

The Practice Nurses workload is increasing constantly and they now provide a wide range of clinics, including Minor Illness, and services to the patients of Nuffield House as detailed further in this report.

MISS ANGIE HEINI

MRS JANE FOX

MRS DIANE SEARLE

MISS SUSIE BOUY

Works under the supervision of the Practice Nurses doing New Registration medicals, spirometry, ambulatory blood pressure monitoring, basic nursing, administration and infection control duties.

MRS WENDY FERGUSON

The secretarial workload continues to rise with increasing volumes of correspondence and other administrative tasks, including the production of documents such as the Annual Report and Health promotion audits.

MS ANITA STEVENS

MRS SUE KENT

MISS ELAINE ALLES

These posts started with data processing functions for the computer system but responsibilities have expanded to include the management of patient registration, production of information and claims for the PCT, running the repeat prescription system and responsibility for the GP Links system for registration data.

MRS ANN YOUNG

MRS FRANCES NORCOTT

MRS SUZANNE JAMIESON

The reception staff are key members of the Practice team and provide an excellent service to the Doctors, Practice staff and patients alike

MRS ANN GRIGGS

MRS EIRA BARRETT

MRS PATRICIA WHEATLAND

MRS SALLY MCGOWAN

MRS CATHY NEVILL

MISS AUDREY STILLWELL

MISS KELLY HARDINGS

Our visiting physiotherapist has long experience of treatment of patients with psychiatric disorders and provides a weekly session at Nuffield House to teach relaxation techniques to patients with a variety of psychosomatic problems.

MRS NANCY MUNN

Another important member of the extended Primary Care team is our Counsellor, who is employed on a sessional basis to see patients with various emotional and relationship problems. Patients are offered up to six sessions of counselling and then may be referred to other agencies for further care.

MRS SANDY BAGNALL

The weekly dietician’s clinic is now well established and provides ready access to this important area of health promotion. Advice is given for a wide range of conditions including obesity, diabetes, pregnancy and lipid control. The dietician works in close conjunction with the practice nurses.

MRS CLAIRE THOMAS

The chiropody service rapidly became very popular with patients and indeed the weight of numbers soon extended the waiting time to unacceptable periods. When the District Chiropody Service relocated to improved premises nearby, we agreed to restrict our clinic at Nuffield House to "medical" referrals only.

Employed by the Harlow Primary Care Trust but based at Nuffield House, These nurses provide nursing care for patients in their own homes when necessary or at their clinics held in the practice premises. They work in close co-operation with the practice nurses.

MRS JEAN NEWMAN

MRS SUE LANE

MRS DIANE SECRET

Maternity care is provided by all the partners in association with a team of community midwives. Patients get to know all the midwives during their pregnancy through the antenatal clinics and various classes. One member of the team is usually responsible for their intrapartum care at Princess Alexandra Hospital, Harlow. Partners are no longer involved in intrapartum care.

The Health Visitors provide advice to parents on the care of children under five and assist in child surveillance programmes.

HEALTH VISITOR PAT ALEXANDER

HEALTH VISITOR KATHRINE ISSITT

SCHOOL NURSE CHRIS DURCAN

CLINIC ORGANISER JEANETTE DAVIS

A phlebotomist from Princess Alexandra Hospital holds a session at the Practice each weekday and Patients can attend to have blood taken for tests requested by the partners and the nurses.

Nuffield House is a purpose-built Health Centre, which was opened by Lord Nuffield in 1955. The Centre has never been owned by the Local Health Authority but was financed originally by the Nuffield Provincial Hospitals Trust as part of an experiment in developing primary care services within the NHS.

All except two of the town’s surgeries were provided in this way which means that local doctors are in the unusual position of renting modern health centre facilities without any of the possible constraints which can occur in some health authority owned buildings and without the problems associated with investment in practice premises.

The Nuffield Trust eventually decided that the time had come to declare its experiment a success and the Harlow Health Centres were put on the market. Harlow District Council was persuaded to guarantee the principle established by the Nuffield Trust by purchasing all the properties and creating an independent "Harlow Health Centres Trust".

Nuffield House is situated close to The Stow, which is the local shopping centre for the surrounding area. There is a covered pram area and a small car park at the front of the building with a common entrance hall, leading both to the practice accommodation and the dental wing.

The practice accommodation consists of a large waiting room from which leads a corridor giving access to the other practice rooms. The waiting room is a pleasant area, which can be used for meetings and social functions of various sorts.

The rest of the accommodation comprises:

filing room/general office with an open-plan reception area

computer room

consultation rooms with adjoining examination rooms GP Registrar room

secretarial office

common room with kitchen

Practice Nurse treatment room

Practice Nurse clinic

seminar room/library/Practice Manager office.

From the waiting room, there is access to the accommodation used by the Health Visitors and Midwives. Apart from their offices, a large room is used for infant welfare clinics, relaxation classes and health education activities.

New rented premises is being developed for 2005. Plans will be available for applicants selected for interview.

Although in the past our catchment area has included the whole of the Harlow District Council area and the nearby communities of Sawbridgeworth and Sheering, a decision was made by the Practice to restrict the registration of new patients within a designated area around the Surgery. This decision had to be made due to our increasing list size and extension of the patient services offered at the Practice. However, this has not affected any existing patients who live outside the new designated area.

Our appointments system is designed to provide a large number of appointments to meet the needs of our patients and to enable the Practice to function efficiently. A number of appointments in each doctor’s surgery are reserved for patients to make on the same day to cater for acute medical problems and to avoid surgeries being fully booked in advance. We also meet the Government’s access requirements by providing a surgery for urgent problems each morning run by a duty doctor. We also have a Practice Nurse led minor illness clinic each morning and afternoon/evening. A surgery on Saturday morning for patients who cannot wait for routine appointments.

Appointments can be made by calling at the reception desk or phoning between 08.30am – 12.00am and 2.00pm – 7.00pm.

For Doctors’ surgeries see next page.