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Last Updated: Tuesday, 26 July 2005, 23:03 GMT 00:03 UK
From zero to hero
London NHS trusts traditionally have some of the worst star-ratings, because of the "complex needs" of a diverse population.

One primary care trust explains how it managed to make an astonishing improvement in just 12 months.

More GPs have been recruited

In 2004, Tower Hamlets Primary Care Trust (PCT) in east London was right at the bottom of the NHS class, with a zero star rating.

But what a difference a year makes.

The PCT has been awarded two stars by the Healthcare Commission to become one of the success stories of the year.

The trust was picked out by the watchdog's chief executive Anna Walker as an example of what can be achieved where diverse and mobile populations create complex health needs.

The trust, which is responsible for a population of nearly 200,000 - half of which are from ethnic minorities, met seven out of eight key targets.

We have made real efforts to engage the community. That is the only way to get people on board
Jeremy Gardner

It failed only on the four-hour wait for A&E - in common with many NHS organisations.

In particular, the trust was praised for improving access to GPs.

The trust said it had increased the number of GPs from 144 last year to 170 in an area where retention of family doctors has been traditionally difficult.

Jeremy Gardner, head of communications at the trust, said the rise was largely driven by the "salaried doctor" scheme, whereby GPs can be employed by the PCT rather than individual practices.

The system allows doctors to avoid being tied into one practice. They thus have the opportunity to explore different areas of primary care while also gaining experience of working in a surgery. It has proved particularly attractive to younger GPs.

Alternative health

Mr Gardner said: "You need more GPs to improve access, but that is not always easy in an area like ours. The salaried doctor scheme has allowed us to attract quite a few young doctors."

The PCT has also tried to make use of alternative health professionals such as physiotherapists based at practices to relieve the burden on GPs.

However, Mr Gardner stressed the key reason driving the improvement in health care in the area was the fostering of partnerships between a wide range of health and social care workers, and the local community.

The trust has demonstrated a genuine commitment to patient and public involvement
Myra Garrett

Over recent years the NHS has looked to build closer ties with local government social services, and Tower Hamlets is no different.

But the trust has also tried to involve community groups to reach out to the Bangladeshi, Somali and Afro Caribbean populations.

For example, a health clinic was set up at a local mosque to discuss healthy eating and exercise with Muslims.

The trust has also sought to get more people to register with a dentist.

Realising that many members of the population were not registered, the trust funded a mobile dentist van to go out in the community to carry out check-ups and some basic treatment.

Of the 3,000 patients seen in just over a year, three-quarters were not registered with a dentist. Half of these went on to use high street practices.

Mr Gardner added: "We have made real efforts to engage the community. That is the only way to get people on board."

Myra Garrett, chair of Tower Hamlets patients forum, praised the way the PCT had involved the local community.

"The trust has demonstrated a genuine commitment to patient and public involvement and we are happy that our partnership has been fruitful."

However, she warned the demands on A&E still indicated a lingering dissatisfaction with the quality of GP care.

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