How colleagues at Exmoor Medical Centre are meeting the challenges of rural healthcare

If you approach Exmoor National Park from Mid Devon, you’ll come across Dulverton, a small town where with provision of healthcare is nothing short of extraordinary.

This is in the main thanks to the unique way that our colleagues at Exmoor Medical Centre, which is run by Symphony Healthcare Services, are providing personalised care to each and every one of their patients.

The model of healthcare even caught the eye of a BBC Radio 4 journalist from flagship rural affairs programme, Farming Today, who paid a visit to the medical centre earlier this month to hear first hand from GP Dr Jenny Capps, as well as one of the centre’s patients.

Jenny is also married to a farmer and explains how Exmoor Medical Centre is different to others in the way it provides healthcare.

“We have a practice population of about 4,000 and we cover a huge area of Exmoor and Greater Exmoor,” she says. “This includes the national park, with the vast majority of our catchment area made up of farmland.

“This naturally means that most of our patients are either farmers, or those living within the farming community.

“My husband is also a farmer, so that brings its own challenges of trying to work while lambing and calving! It’s a huge benefit, as I know all about the difficulties that people in our farming community – our patients – are facing, so I have that good understanding of their needs.

“I think it really break downs those barriers, as our patients know that I have a real empathy of what they’re experiencing.

“At an appointment we might also chat about general farming topics, like what type of sheep we have, the challenges of lambing, and the general difficulties that affect everyone in our community. I’ve found that this really puts them at ease when I see or speak to them about their medical needs.”

The biggest challenge and barrier that Jenny feels that those in the farming community are faced with is being able to access healthcare.

“I know firsthand that farmers work long hours, starting very early in the morning and finishing late at night, so they often struggle to contact us during typical GP practice hours,” she continues.

“To help with this, we’re able to offer an online booking service where patients can tell us about their concerns, and we can then address them on the next working day, or sometimes even on the same day, which is pretty unheard of these days!

“When filling in the online request, patients can also tell us whether there’s a particular time that we can call them back, so if they’re likely to be busy lambing all morning and not able to take a phone call, then they can ask us to call at a specific time, which we’ll do our best to facilitate.

“Once a patient requests to speak to the surgery, they’d get a phone call in the first instance as we find that most issues can be sorted out over the phone. If they do need to see a doctor, then it could be a better use of time for them to have some blood tests first from one of our nurses, and then be booked in to see a GP face-to-face.

“But patients can also request a face-to-face appointment immediately, and based on the description of their medical issue, we might book them straight in for an appointment at the surgery.

“We have a really dedicated team at Exmoor Medical Centre and I think we use our resources wisely. By having this total triage system, as clinicians we are in effect in charge of our days, and can prioritise those most at need without them going through a standard three week queue.

“For example, it might be that someone contacts us with back pain, and they’d likely be better seen by our First Contact Physiotherapist, Dawn, who’s here every other week. They don’t need to see a GP to be referred into that service either, which makes things easier.

“It may be that the patient has a complex health need, so we may need longer than the traditional 10 minute appointment, whether that be on the phone or face-to-face.

“We can also redirect people to a pharmacy, and we have an excellent dispensary in our building, which offers a home delivery from volunteer drivers to the whole of our rural area too – we’re very lucky to have that service here.”

It’s not only the GP practice where farmers can get advice and signposting for their medical needs, as they can also visit a health hub at the local farmers’ market at Cutcombe, near Wheddon Cross.

It’s one of three health hubs based in farmers markets, with the other two at Sedgemoor Auction Centre near Bridgwater and Standerwick Market, just outside Frome. The idea for the health hubs came from the family of the late Derek Mead, who was a well known farmer in the Sedgemoor area.

Nurses and psychological wellbeing practitioners at the trust run the hubs, which have been funded by the NHS Somerset ICB, and set up and hosted by a range of rural charitable organisations.

“We’re very lucky in this community to have a rural health hub, which is attached to our local livestock market at Wheddon Cross,” continues Jenny.

“On market days, our nursing and talking therapies colleagues are available to offer free impartial advice, so people can just turn up without an appointment. It also offers a chiropody service, with foot health being really important to farmers who are on their feet for most of the day.

“The main beauty of the hub is the ability of our colleagues to signpost people for an assessment, care or treatment where needed, either to charitable organisations, or to us in the GP surgery.”

Jenny says she’s very proud of the access and services available at Exmoor Medical Centre, which was also given the highest level of praise possible by the national health regulator as recently as 2022.

“I really enjoy coming to work, and particularly love it when I see someone from the farming community, as we can have a chat about how lambing has gone or whatever,” says Jenny.

“Our practice has an ‘Outstanding’ Care Quality Commission rating, and I think that shows in everything that we do – I’m so proud of everyone for achieving this.

“I honestly think it’s a privilege to work here and serve these amazing people and I wouldn’t swap it for the world!”

You can listen to Jenny’s interview on BBC Radio 4’s Farming Today programme here.