Peak practice that comes top for service

Deep in the heart of the Peak District down a small side road off the main high street in Glossop, Derbyshire, lies Manor House doctor's surgery, the apple of John Major's eye and the super-surgery of the Conservative future. In his speech to the Tory party conference last week, the Prime Minister used Manor House as a prime example of a flourishing fund-holding practice.

"Waiting lists have been slashed," he said. "People no longer have to trek to the district hospital ... more money is spent on patients, less money spent on paper work. This practice could be the model for the future."

The holders of last year's Fundholding Practice of the Year award, Manor House is the surgery that offers everything - osteopathy, acupuncture, aromatherapy, counselling and physiotherapy, all carried out by an in- house team.

According to the practice's senior partner, Dr John Oldham, all these services have had a significant impact on hospital referrals, carried out at less cost.

"We are doing more at the surgery for the individual patients" he said. "Many things that in the past might have been referred to the district hospital can now be done locally. Our anticoagulant clinic is one of the most popular and successful services. In the past, patients would have to travel 15 miles to one of the two local hospitals but now they come to the clinic for treatment instead.

"We analysed the cost of this new service and it was at a much-reduced cost to the National Health Service. The same saving across the whole district would save the NHS pounds 750,000 a year."

Dr Oldham is immensely proud of the practice's achievements, in particular its funding of a local cottage hospital which saw the inauguration of a "homeward-bound unit"A six-week rehabilitation programme was set up to maximise mobility for patients who previously were considered borderline for home management after hospital care. Now more than 60 per cent go home, saving the NHS pounds 0.5m a year.

Other in-house services include chiropody, gynaecology, audiology and dermatology teach-ins. "The waiting time for dermatology used to be 90 weeks under the old regime," Dr Oldham said. "Now it is six to eight weeks."

For the people of Glossop and the surrounding area the emergence of Manor House has been a godsend. Many used to spend time and money travelling as far as Manchester General Hospital for treatment.

One patient who has gained significantly from the changes is Margaret Gainey. Attached to a non-fundholder practice, she is 69 and suffers from asthma and acute bronchitis which has led to a blood clot on her lung. Her GP arranged for her to be admitted to the anticoagulant clinic at Manor House to save her the 15-mile trek into Manchester. Mrs Gainey now visits the clinic, just four miles from her home, once a month.

Another patient to benefit is 68-year-old Frances Kane. "We all consider ourselves very fortunate because we never have problems getting an appointment," she said. "Everyone is so nice here, I'm not surprised Mr Major was impressed."