Delivery of the right care in the right place

Principal Medical Limited, Oxfordshire and Hampshire

Principal Medical Limited (PML) is a not-for-profit healthcare provider delivering NHS primary healthcare contracts in Oxfordshire and Northamptonshire. It is run by local GPs for local patients, and has nearly 20 years of success in delivering high-quality NHS primary care services.

Within primary care settings, PML strives to provide the right care in the right place at the right time. In response to patient demand, PML created the Community Gynaecology Service, working with local GP practices to provide timely treatment and advice in accessible primary care settings.

The service is hosted at scale and welcomes referrals from GPs throughout Oxfordshire, ensuring that patients across the county receive the same high level of care and reducing local variation. The team offers both telephone consultations and face-to-face appointments at various locations, including Oxford City, Banbury, Didcot, Kidlington, Ardington and Long Hanborough.

The foundation of the service is a team of experienced GPs, overseen by a community gynaecology clinical lead, all with a shared mission to deliver specialised care for women across Oxfordshire. Collaborating closely with the Oxford University Hospitals NHS Foundation Trust (OUHFT), the Community Gynaecology Service ensures patients receive comprehensive care that benefits from the resources of an at-scale provider and cross-system partnership. A similar service operating only at practice level would provide less equity of care, and struggle to forge partnerships with trusts.

The Community Gynaecology Service takes a practical approach to women's health, addressing a wide range of gynaecological concerns and providing tailored support for patients aged over 14:

• Intrauterine devices (IUD and IUS).
• Managing post-coital bleeding.
• Support after failed cervical screening tests.
• Addressing heavy menstrual bleeding.
• Inter-menstrual bleeding.
• Investigating lost coil threads.
• Prolapse assessment and ring pessary fittings.
• Polyp management.
• Menopause support.

In response to demand for a broader approach to women's healthcare, the Community Gynaecology Service introduced a dedicated menopause service in 2022. Furthermore, the team recently introduced endometrial sampling, where a hospital consultant holds face-to-face sessions in the community to take samples of the womb lining. This helps reduce the number of onwards referrals to secondary care and allows patients to be seen faster and closer to home, ensuring that there is no delay to pain management or diagnosis. This expansion to the service also provides an opportunity to upskill existing GPs within the service, allowing for continued innovation and supporting the onward sustainability of the service.