Essex County Council had created the new town with little or no thought for healthcare provision but a group of patients saw this as a challenge. I worked with them and between us we achieved a great deal … so it was time for ‘the next stage.’

I was keen to make use of our new computer at a time when these newfangled gadgets were virtually unknown within the NHS. There is a side to general practice which sounds somewhat boring but is nevertheless supremely important—keeping records in a form which enables GPs to be proactive. The computer provided us with a readymade ‘age sex record.’ This is a slightly misleading term as it implies that this is something designed with the intention of creating embarrassment or telling patients off; “Sex? At your age? Really!”

In fact, though, such registers are crucial in general practice for screening … ensuring targeted programs, improving health outcomes, and optimizing resource allocation. These records help to identify individuals at higher risk for specific diseases and encourage early intervention, potentially preventing serious health problems and improving overall health and wellbeing. 

At that time what national screening programmes existed were rather hit and miss.

One example: recall for cervical smears left a lot to be desired. GPs kept records … as often as not in the jumble of paperwork that was the ‘Lloyd George‘ notes (the little brown envelopes into which letters and results were stuffed). A few chose to have their smears in private facilities so they weren’t recorded on the NHS system and some employers (for example Marks and Spencer) at that time offered health checks – including smears. The records were fragmented so it was hard to keep track—but our patients kept much better records than we did.

It was important to keep on top of this as, at that time there was no HPV vaccination which has resulted in a massive drop in the number of young people getting conditions linked to HPV (human papillomavirus), such as cervical cancer and genital warts—so we wanted to reduce the number of Jade Goody type cases by picking up changes at an early stage (precancerous lesions) which were easily treatable.

To improve the situation we set up a ‘smear campaign’. This was widely advertised and we installed a dedicated phone line with an ‘ansaphone‘. so so women could call in 24/7 to let us know when they last had a smear. We could then tie this in with what records we had in their Lloyd George notes to make sure nothing had been missed and they were being recalled appropriately.

We didn’t know what effect this and other similar initiatives were having at the time but, when better records were kept by the NHS, we were told that, for our patients: “Female and male life expectancy is above the local and national averages.”

By this time general practice was beginning to reflect the nature of the ‘young town.’ Many of the residents had moved out from the metropolis because, in SWF, for the price of a small flat in London they could buy a 3 or 4 bed-roomed family home. Accordingly the birth-rate was high. The ‘consultation rate’ was similarly high and we attributed this to that fact that, in moving to a new town, young parents had lost the support network they had previously enjoyed … so, until they had ‘bedded in’, the GP surgery was often the first port of call for advice. Much of this advice was provided by my wife, Sue ..… so she was greatly embarrassed when, on a visit to Asda, our daughter (then a toddler) decided to lie down and have a protracted fit of the screaming abdabs. By an unfortunate coincidence, many of the young mothers to whom she had dispensed advice on what to do in similar circumstances just happened to be there at the time.

There was an influx of young GPs to the town and, taking their cue from the residents, they simultaneously started having babies of their own.

Tune in for next week’s exciting instalment!

Dr John Cormack