GP and manager form social enterprise to save practice for homeless

A GP and practice manager have saved the PCT-led specialist homeless practice they run from being put out to tender by setting up a social enterprise to take it over themselves.

Dr Robson and Juklie Madley

Meadowell, in Watford, Hertfordshire, which runs a drop-in service alongside booked appointments, was due to be officially opened this week by the mayor of Watford after GP Dr Tim Robson and practice manager Julie Madley won a 'right to request' bid to take it over.

The right to request scheme allowed staff to apply to run services offloaded by PCTs when the last government split NHS purchaser and provider functions. GP reported last year on a rural practice in Bedfordshire which won a similar bid (GP, 20 May, 2011).

Meadowell, which opened in 2003 to provide enhanced primary care for the homeless, now has 600 patients and employs a substance misuse nurse and two part-time GPs.

Dr Robson said Meadowell was among the country's smallest social enterprises.He said taking on the practice was initially about protecting the existing service, but the practice has now bid for extra funding to improve. 'We are going to set up hepatitis C treatment as an outreach service. Patients are more likely to comply with treatment here, the long-term savings are huge,' he said.

Ms Madley said: 'It has been a struggle because it is something new. The PCT had to make a choice to put the service out to tender or could have changed the service so we employed our right to request and had no competition. Patients say they like to come here because nobody judges them.'

Former patient and designated patient champion Stan Burridge, 46, was sleeping rough when he first went to Meadowell in 2003; he now has a flat and has had several jobs. He said: 'If I hadn't got that care I would not be in the position I am now.

'The biggest difference between being managed by a PCT and being a social enterprise is that it gives them the freedom to develop services based on the needs of the patients.'

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