Published: 21/02/2002, Volume II2, No. 5792 Page 16
The lights are on, revealing immaculate showhouses. All the manicured lawns are closely mown. There is even a street called Quidditch Lane, in honour of the vigorous, broomstick-mounted ball game played by Harry Potter and his chums.
Cambourne certainly has all the hallmarks of a new development.
So could a new town offer a clean slate for local health services, to create new models of care without facing down the obstacles of tradition? Dr Peter Bailey, who has set up the new town's primary care practice, certainly hopes so.
Over 3,500 houses are planned in the new town, situated in the 'silicon valley' between Cambridge and the old market town of St Neots. The houses are being built by developers in three clusters, each around a 'traditional' village green, and will, ultimately, provide homes - both owneroccupied and social housing - for some 15,000 people from growing families to retired couples.
But the area is also the site of ancient settlements. Recently, three Iron Age skeletons were unearthed and archaeologists are probing for more clues to the past, alongside builders creating the future. Even the spanking new Monkfield medical practice has an historic link. It is built on the former lands of the Benedictine Priory at St Neots, Dr Bailey says.
But he is more concerned with Cambourne's future than its past.
The first houses started going up on the greenfield site in 2000 and all the homes are due to be completed by 2015. 'It has been called an artificial community, a middle-class enclave, even Disneyesque, ' says Dr Bailey. 'But Cambourne is as real as any other community - there are people here struggling with the problems of jobs, relationships, children.'
Dr Bailey leads the team based at the new medical practice, which has been funded by a type-2 initial practice allowance. This is a nonprescriptive fund, available since 1966, which meets all practice expenses, including GP pay, for the first five years if the local health authority can demonstrate that the new community cannot have its general medical services provided by other means, such as by a neighbouring practice.
'For the next five years I do not have to follow the normal economic rules of general practice, ' Dr Bailey explains. 'I do not have to make a profit to pay myself and the staff. I have a guaranteed income of£73,000 a year and all expenses are met, which gives me the opportunity to experiment.'
Dr Bailey's hope has been 'that my role as a GP would see me only doing the things that I can do and that, if the primary healthcare team had other pathways to offer patients that met their needs, I could concentrate on the primary care physician role.
'I expected that Cambridgeshire residents would want an information-based service - there is a 95 per cent internet connection base here, and the reference library in Cambridge has a very high rate of inquiries about medical issues.'
With joint funding from the library services and health, he has appointed a health information officer, whom patients can contact directly, and who will help the practice team to find research literature and information.
Dr Bailey can issue 'information prescriptions' to patients. 'I might see someone in the early stages of, say, osteoarthritis. I can give them an information prescription so that some of the questions they may have can be answered in the material given to them by the health information officer.'
The practice also has a clinical pharmacist, a joint appointment with high-street chemists Boots, who is available every day to give advice about minor ailments, selfcare, as well as advice about medications and repeat prescriptions.
Monkfield also has a well-family service co-ordinator, supported by charity the Family Welfare Association, to discuss with patients problems ranging from finances to depression to children.
Dr Bailey also seeks innovation in the 'behind the scenes' posts - the practice's service development manager is a human resources specialist, part-funded by Lifespan Community trust. A part-time 'research and learning' post, with connections to Cambridge University's department of general practice, is helping to evolve techniques to choose which areas to focus on.
A GP assistant works three sessions a week and two nurse practitioners are developing an integrated community and practice nursing service. A patients' user group is also up and running.
It is yet to be seen whether the pilot will increase patient satisfaction or even save money. For now, Dr Bailey is enjoying his experiment: 'Although I am technically a single-handed GP, I have never felt more a part of a team, ' he says. 'I also feel well-supported by the primary care group, the community trust, the university and the organisations with whom the practice shares appointments. It is a happy place to work.'
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