Integrated health at Cullompton
Although thousands of GP practices across the UK contain complementary elements, few have the luxury of a fully integrated service. College Surgery in Cullompton, Devon is one of the exceptions. We went to explore the new building and talk to staff.
The first sign that this is a slightly unusual surgery are the raised organic growing beds in the middle of the car park. Then at the entrance there's a sculpture of a traditional Green Man - sitting next to an outlet of Boots. The herbs in the nearby garden have traditional handwritten signs - which on closer inspection include very 21st century notes on medical efficacy.
College Surgery marries up the orthodox with approaches that usually lay well outside the GP's sphere.
The new practice was the brainchild of Dr Michael Dixon, who has long been a supporter of integrated medicine, and his strategic practice manager, Wendy Evans. They previously operated a small practice in central Cullompton, but after years of lobbying their PCT managed to get official blessing for the large new surgery on the outskirts of the town. The place now buzzes with nine GPs as well as nurses, PCT staff and - innovatively - two dozen or so complementary practitioners who rent rooms in part of the building.
Complementary health practitioners are all vetted before they take rooms at the practice. Dr Dixon says 'obviously not all patients can afford complementary help, but many therapists are charging reduced rates. Patients are often keen to try a therapy, if they think it will help with a condition.' The offering is very wide: from massage, acupuncture and herbal medicine to healing and thought field therapy.
The surgery also has big plans to educate patients about food. Simon Mills, resident herbalist, has been leading the development of the herb garden, which is in the shape of a body. Herbs are grown on the parts of the body that they affect: echinacea for lungs, chaste tree for gynaecological problems. Mills plans to sell herbs to patients next year. A cafe is also being built with space for 50 people. The surgery hope to offer tailored food to patients; showing them how to cook to better manage diabetes or heart disease.
If there's a downside to the integrated approach, it's that there's just so much on offer. It's hard sometimes to convey to patients all the options that they have.
Boots the Chemist has a wide range of herbal remedies and stocks products that they know GPs will recommend to their patients. An increasing number like St John's Wort are licensed ( to comply with the European Herbal Directive that becomes law in 2011) thus guaranteeing quality for both the patients and the GPs suggesting them.
There are also plans to bring services typically offered in a hospital to the surgery - including chemotherapy treatments. Staff hope this will help patients to avoid unnecessary longer journeys and get help in familar surroundings.
Michael Dixon says 'I got into the integrated approach for purely selfish reasons. I used to dread appointments with patients with conditions from back pain to allergies, where modern medicine has little to offer. Now I'm able to steer people towards approaches that help them to get better.'
Patient involvement is an important part of the picture: they can borrow books on complementary healthcare from the surgery. There are strong links with Natural England's exercise for health programme. Dr Dixon says 'I've seen people shrink by several shirt sizes just from the exercise programme alone.' There's also a health check room where patients will be able to measure their health at important moments in their lives: as teenagers, new mothers, and post 50.
Practice manager Wendy Evans says 'If there's a downside to the integrated approach, it's that there's just so much on offer. It's hard sometimes to convey to patients all the options that they have. I think some don't appreciate quite how innovative it is to have so many choices.' The practice has recently employed Ruth Tucker as their full time health facilitator to bring it all together.
Persuading the Primary Care Trust to fund such an innovative project was a question of luck and persistence. Though all the services were previously housed more cheaply in separate places, the place is now a flagship service, a blueprint for future development.
Although around 100 people work at College Surgery, the atmosphere is overwhelmingly homely. Lord Darzi's polyclinic plan has been criticised by many who fear GP practices will turn into vast impersonal pill machines. College Surgery shows that it is possible to marry convenience with the human touch.
Comments
Chris Francis
December 11, 2008
It is very refreshing to hear something like this is actually up and going. This idea is still a planning stages and to see something like this working (it will work).
Pat Cull
December 08, 2008
Your surgery sounds great. Please don't forget the patient who suffer from severe and enduring mental illnesses such as schizophrenia and bi-polar etc. The present changes in Benefits and working are causing a great deal of concern in such patients. Some of course can work, often with difficulty. Others would return to the florid state of their illness with the pressures put upon them. In the present state of the economy with many people suffering loss of pension, being made redundant etc. I think that mental illness, mostly of the less severe type will bring a great deal of pressure on the NHS and those who work in it. But long term chronic mental illness already brings stigma and added anxiety, and also great difficulty for carers. May I recommend MICA to you on the web.Helpful to all.
Jacqui Pamment
December 08, 2008
It was wonderful to read on your site of the new integrated surgery. Lets hope that is the start of things to come. My family have suffered from a of lack of co-ordination.My daughter was born 3 months early, to a mother already 41years. Her problems are slightly nerological and amazingly she has managed to get to university. even after a suicide attempt when anti-depression drugs reacted badly with her OCD. Unfortunately Uni brought too much trauma, I had to make quite a scene to get an appointment with the Mental health Unit and that 5 weeks on. Thank heaven, my daughter was so deperately unhappy she asked me to find help.I searched the Internet and came up with a psycho -hypnotherapist ( Human Givens trained)nearby, After 5 treatments and serotonin percursers she is a changed person.