GPs practise in a high-street store

GPs in Dorset have opened a branch surgery in their local Boots the Chemist store. Prisca Middlemiss investigates

Virgin, Asda and Sainsbury’s have all said they would be interested in providing more high-street GP surgeries. But Boots got there first.

In January 2007 the Carlisle House practice in Poole, Dorset, became the first NHS provider to offer patient services from retail premises by establishing a branch surgery in consulting rooms vacated 15 months earlier by dentists in Boots in the Dolphin Centre, Dorset’s largest shopping complex.

The patients, the four Carlisle House GPs and Bournemouth and Poole PCT agree that so far it has been a resounding success.

Given this success and Boots  stating it has space to spare in ‘potentially 200 other locations’ and is now in talks with other PCTs, this could be the first of many such partnerships.

Patient benefits
The benefits for the patients are unmissable. Feedback has been ‘very positive’, said Dr Mark Nelms, Carlisle House’s lead GP for the project.

Almost all consultation slots for the GP and nurse practitioner who run morning and afternoon sessions Monday to Friday are filled, said practice manager Hugh Marsden.

‘It’s a great position. We are delivering services where people want them,’ said Mr Marsden.

‘If we tell a patient their appointment is at Boots, there has been no resistance and for many it’s a distinct advantage.’

It is not only the patients with mobility problems who appreciate the lift, the taxi rank and the bus stop at the door of the shopping centre — none of these conveniences are available at the main surgery.

For the practice, it’s a ‘cost-free agreement’, said Dr Nelms.

The suite, known as the Healthcare Centre, is rented on a 10-year lease from Boots by the PCT which covers the practice’s costs with a top-up on its notional rent.

‘We are supporting the practice to open a branch surgery using normal arrangements for premises under GMS rules and regulations,’ said Rob Payne, PCT project manager.

The PCT is also paying the three reception and administrative staff.

At a quarter of a mile away, the branch premises are conveniently located to the main GP surgery. Occupying just one of the nine consultation rooms in the Healthcare Centre, the practice finds itself at the heart of ‘an intermediate care hub’.

Multiple services
In the other consulting rooms are NHS practitioners. They are offering secondary care services to all patients registered with Poole practices.

Phlebotomy is already installed, and echocardiography, orthopaedics, physiotherapy, podiatry and an acute back pain service are following in the future, as well as dietetics, smoking cessation, medicines management and possibly community dermatology.

‘My vision is an intermediate care centre for Poole GPs,’ said Dr Nelms.

Boots was ‘very keen’ to have a GP presence in the healthcare centre, said Dr Nelms.
From the company’s point of view, the centre is expected to increase trade.

Boots’ area manager Garwyn Morris says: ‘We believe we’ll get an increase in footfall and will be interested to see if it will have an effect on the retail business.’

There is also the possibility that Carlisle House could expand its branch surgery in the future.

‘Boots is possibly looking to expand its store further so there would be potential for us to expand the number of consulting rooms,’ said Dr Nelms.

At the same time, most practice patients are still seen at the main surgery and Dr Nelms is alert to perceptual dangers.

‘There could be a danger of being subsumed by Boots’ larger corporate set-up,’ he says.
‘If we were entirely located within the Boots centre in terms of our image it would be looked on as being a little part of Boots.’

The practice has no intention of adapting to shopping centre hours or opening at the weekends, Dr Nelms stressed.

When the Carlisle House GPs signed contracts last November, they committed themselves to a 12-month deal. On current showing, they will be very happy to extend their contract. Opportunities for other practices to work in this way are being encouraged by the DoH. Retailers are being targeted as part of its Fairness In Primary Care Procurement programme with the promise of 30 contracts to be put out to tender this year (GP, 23 March).

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