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Last Updated: Sunday, 11 April, 2004, 23:56 GMT 00:56 UK
The GP practice of the future?
Patients wait just 20 minutes to be seen by a health professional
Is this the general practice of the future?

BBC News Online examines why a GP surgery in Peterborough is attracting attention at the highest levels of government

Dr Nalini Modha sees just one in every three patients who walks through her surgery door.

But far from being hauled before the General Medical Council, this Peterborough GP is the toast of many colleagues and even government ministers.

Dr Modha and her GP husband Jitendra have set up what could become the NHS surgery of the future.

We have changed the way the practice is organised
It's a surgery where doctors take something of a backseat and where nurses and receptionists are at the fore.

It's a surgery where patients are more likely to be seen by a nurse than a doctor and where they are unable to make appointments.

But it's also a surgery where patients wait just 20 minutes to be seen by a health professional and where GPs are always available to see the sickest patients.

Ministerial visit

Given all that, it is perhaps unsurprising that Thistlemoor Medical Centre has attracted attention at the highest levels of government.

In recent months, the practice has opened its doors to Health Minister Rosie Winterton as well as senior members of the British Medical Association and neighbouring doctors.

So what is so special about Thistlemoor Medical Centre?

Some GPs are afraid to give nurses more power
"We have changed the way the practice is organised," says Dr Modha.

"We have changed the way we, as GPs, work and changed the way our nurses and receptionists work."

The changes are apparent as soon as the patient walks through the door.

In most other practices, receptionists will tell patients to "take a seat and the doctor will see you shortly".

At Thistlemoor, the receptionists or healthcare assistants to give them their proper title can carry out basic health tests, such as blood pressure checks, and can also give general health advice.

"All our medical records are on computer and we don't take appointments, so they have time to do this," says Dr Modha.

All of the patients are then seen by one of five nurses. They carry out an examination and decide what treatment, if any, is needed.

Computer assistance

The nurses use a computer-based protocol, developed by Dr Modha, to guide them through the consultation.

The protocol sets out what questions they should ask and treatment options. Dr Modha has drawn up over 100 protocols, covering conditions from headaches to chest pains.

"The protocols mean nurses can now treat the patients. They are happy and the patient is happy," says Dr Modha.

It has freed up my time to enable me to do what a doctor needs to do
"If the case is more complicated or if the nurse or patient needs reassurance then we are on the other end of the phone or down the corridor and can pop in to offer assistance."

The system, which has been up and running for more than a year, has proved popular with patients.

"We haven't had any complaints," says Dr Modha. "Of course, we have had niggles here and there but we have explained to patients that we are more available to them now than we were before.

"In the past, patients may have had to wait hours to see us but now we are available to see them much more quickly.

"It has freed up my time to enable me to do what a doctor needs to do.

"And patients can still ask to see us if they want to. They are never denied access to a GP."

Dr Modha believes that other GP practices around the country could benefit from adopting a similar system.

"Not every patient who comes through the surgery door has a medical problem.

"In some cases, they are just looking for a little bit of advice or some reassurance.

"Our system enables us to filter those patients through and to ensure everybody's time is used more appropriately," she says.

"I think some GPs are afraid to give nurses more power.

"Some worry that the nurses may miss something and others are concerned about their own role - what will happen to doctors?

"But they shouldn't. The system works for doctors, nurses and patients."

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