Dr Lauren Parry
Lauren Parry has been a GP in Southwark since 2012. She was a long-term locum before becoming a salaried GP. She lives in the borough and juggles bringing up three young children with clinical commitments and her role as a director of a GP federation. With not much spare time for herself she cycles everywhere to help switch off her thoughts for a while.
"When I became a salaried GP I became involved in representing the practice at locality meetings. I could see there was a need for change in the practice, in the system and in patient care. I work in a practice with probably the most deprived patients in Southwark. I wanted to look at how we could work better with social care and the voluntary sector to help them. Then I was approached to join primary care development programme on returning from maternity leave.
I wondered how you could share experiences and expertise
I hadn't realised quite how much the system was intending on changing. I saw it as an opportunity to look outside of my practice for ways of doing things differently. During my locum work I'd seen how different practices approach essentially the same issue. I'd seen the strengths and weaknesses and I wondered how you could share experiences and expertise. Lots of people stay in the same practice for years – how do you show them there is a different way? Or if they have a really good approach how can they share it. There was no formal way of peer learning.
GP practices are individual businesses. But for your business to survive you don't need your neighbour to fall over. There are enough patients to go around! We're not really in competition with each other. If South Southwark did really well altogether we could each be much stronger. We'd have a much more unified voice across the system, we would have much more power, to drive money into the system, find new ways of working, or contracts that we won't have if all 43 practices are operating individually.
You have to recognise there is a need for change
I found that I like strategy and I'm very amendable to change. Part of that is because I'm relatively new to general practice and not wedded to any previous way of working. I know from my academic study that primary care in England is world-renowned. It's a hugely important and a valuable part of the system but you also have to recognise that there is a need for change. You have to fight to preserve the parts that ought to be preserved and be willing to change other stuff. You can't have the same way of working with an ageing population with complex morbidities. I was able to develop my thinking on ideas I already had prior to the programme.
The best things about the programme were meeting other people working in primary care in Lambeth and Southwark, having space to think about our frustrations and to be able to think more creatively about how to solve them, and working through these issues with people with different experiences. I like to bounce ideas off people rather than sitting thinking on my own.
I think there is a risk in general practice that you go into your room, shut your door and see your patients and there isn't that need to see what's going on in the wider world. Some people do just want to go to work and then go home, but I wouldn't sit for years complaining that something wasn't working without naturally wanting to do something about it. The programme has given me the skills to do that.
We still need GPs and practice managers on the ground
The expectations on us to be leaders of this system change and the time need to do everything was the most challenging. It eeked into our personal time. I've ended up stepping away from clinical commitments and all of our federation leadership team have removed themselves in some way from clinical sessions. But at the same time we need GPs on the ground and practice managers attending to their duties. There is a sustainability worry that quite a lot rests on so few. It's something we have to think about.
We are in a challenging phase now, we have the early adopters on board but we have to work with all members of the federation. We have to protect ourselves against losing momentum and drive.
Dr Lauren Parry is a GP at Queens Road Surgery, Peckham, and a director of Improving Health Ltd, the South Southwark GP federation.
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