6. QAD Architects ▪ www.q-ad.co.uk
2.0 Design Concept
PRIORY MEDICAL GROUP
• Consider Priory Medical Centre as hub.
• Radiate links to Group Surgeries
• Establish brand / association identity
This is Priory Medical Centre
Based in York and part of a group of 9 practices
PMG was founded in 1946 and has since grown to become one of the largest GP Groups in the UK. Despite our size our core values are to maintain the Family Doctor ethos and you are assured of the highest level of medical care and attention at all times.
Patient List totals 53,500. A training practice with links to Hull York Medical School and the Yorkshire and Humber Deanery.
QAD were contacted as a result of Dronfield being published because of the vision that the practice had in seeing what they could achieve – not repeating the mistakes of the past. Project was carried out during 2009.
Funding of £525K via the deanery was available for the whole of York
QAD listened to the aspirations of the practice – To increase the number of trainee GPs but they did not have the space to train them
Then carried out a site analysis
Asked many questions about how they worked and issues surrounding the environment in which they worked
Poor use of existing natural daylight (roof lantern)
Poor construction detailing / junctions likely to lead to leaks etc
Heavy overbearing canopy appears forboding rather than welcoming
Overall dull and uninviting appearance
Disperate facilities lack a sense of visual cohesion
Where is the entrance, it appears to be the dentist at present
The disperate nature of development apparent on plan also
Patient experience, series of adjacent waiting areas for a facility of this size seems inappropriate and inhospitable
Non HTM compliant spaces infection control issues
Leads to a lack of connection with staff, poor control of access into semi private area
Provision of only 1 patient wc (oversized)
Mix of staff facilities with patient (kitchenette)
Extremely long patient travel distance to far consulting rooms
Basic staff safety on the limit with convoluted fire escape routes etc.
Staff facilities at first floor dont have the best layout
Kitchen accessed from secretaries office
Inappropriate detailing regarding robust quality exemplified by the stair quality
Inadequate wc provision
Dark and claustrophobic space caused by the cramming in of facilities.
Clever reorganisation and better efficiency of space allowed the focus of their operation to be at Acomb
The work that was carried out supported an application to the deanery but was done on a part speculative basis by QAD on the basis that if the bid was successful we would then be commissioned.
QAD went away and considered options as to a way forward
Within the confines of the constrained budget we looked to achieve the maximum
By solving as many of the issues / challenges as possible with the new scheme rather than creating them
Minimal Intervention
Improvements in the experience for both patients and staff
These included:
Clear and concise and welcoming entry / waiting and monitoring
Simple and shortened patient journey as it is now accessed from both sides
Better admin connectivity with the incorporation of a new private circulation core
Creating a coherent core with adequate wc facilities and without conflicts in circulation / zoning
Made all consulting rooms HTM compliant
Better patient facilities
From 8 – 10 consulting rooms + Treatment + counselling + interview
Halved the travel distance by opening circulation from both ends
Fully utilise the natural light opportunities that are already there
Relocated staff and new staff facilities
Better staff communication and efficiency
Aesthetic development worked on together with the practice the planners and other stakeholders
The bold vision achieved all of the available deanery funding for that year with a net benefit of being able to train up to 10 GP registrars in the new facility each year
We revisited the practice this year, as is our format to learn from projects
Here is what they said
“It is a professional environment delivered to a much higher standard than other medical centres that they know of, due to aspects such as the lovely light bright and open environment that has been created.”
The largest unforeseen benefit that the project has brought is that “It has set a new standard for other projects within PMG. The building has facilitated new and more efficient ways of working and as a result has altered the mindset of both staff and partners.
There has been a shift in the expectation of patients regarding the quality of service that they receive, “this building both contributes in raising the bar of both expectation and delivery.”
Business opportunities have been borne from the increase in productivity. There have been great efficiencies achieved by the facilitation of the whole of the admin team being housed on this site. This has in turn facilitated new ways of working and enabled better relationships between staff.
Examples include; visibility of workflow in turn this makes the team management so much easier, as a result of the increase in productivity this in turn enables them to commoditise spare capacity. This is done in practice by providing administrative services for other medical practices.
To facilitate the above the new building “Makes us proud to bring surgery staff from other practices here because it gives the right impression from the start”. Comments that have been received include “It feels like a private clinic”
QAD explored with Martin how he had been as successful as he was in raising the funds from the Deanery to facilitate the development.
Fundamental to the development being able to achieve all of the aims and ambitions of the practice was the successful bid for the entire capital fund for that year for the entire city of £525K all going to PMG.
The reason for this is that PMG have a track record of delivery. The quality and standards that they had set regarding teaching has a history of being very high quality and being very successful.
The GPs that PMG have trained have had a tendency to be very high performing and have in turn gone on to become partners at other practices across York.
All of the above in turn boosts the kudos of the medical school.
PMG have a fundamentally different approach and mindset. The increasing adversity faced by practices since the advent of the revised GP contract in 2004 has led to the erosion of income of other practices that have not geared themselves up to the necessary increased productivity requirements. PMG have taken the view to control the controllable and look for opportunities that arise from the various Department of Health dictats.
They have a shared vision that involves patients at its centre, then look to how can they deliver the best possible care in the most cost effective manner.
This is achieved by recruiting the “right kind of staff” Staff who are ambitious and want to be part of pushing things forward.
There is in turn a pathway for all staff to develop.
A key part of what they do and how they go about things is that it is not meant to be at the expense of others, they look to assist other practices to achieve their goals in a similar manner.
