A unit where doctors are much the equal partners

OneWelbeck, founded in Marylebone, London, by over 100 specialist investors, is one of the country’s largest facilities for diagnostics, therapies and minimally invasive surgery. Some of its leading consultants tell Independent Practitioner Today all about the big attraction of being involved. 

They are:

Prof Jane Setterfield, consultant dermatologist and oral medicine specialist, chairwoman of OneWelbeck Skin Health & Allergy

Prof Guri Sandhu, consultant laryngologist and head and neck surgeon, chairman of OneWelbeck Ear Nose & Throat

Dr Natasha Beach, sports and musculoskeletal medicine consultant, OneWelbeck Orthopaedics

Prof Dame Lesley Regan, consultant obstetrician and gynaecologist, chairwoman of OneWelbeck Women’s Health

How long have you worked at OneWelbeck and what attracted you to having your private practice there?

Prof Setterfield: I have worked at OneWelbeck for eight months. I was attracted to practice there for several reasons, 

But, fundamentally, I loved the concept of being able to select a team of dermatologists, allergists and surgeons who are all highly regarded and experienced and whom I knew and trusted to provide excellent patient care across the whole field of skin health.

Prof Sandhu: The Ear, Nose and Throat Clinic at OneWelbeck has been running since the beginning of 2021. The attraction was the ‘shared ownership and shared profit’ model. 

The consultants have shared in all the decision-making with respect to the clinic infrastructure and the number and nature of support staff.

Dr Beach: I started at OneWelbeck Orthopaedics when it first opened in spring 2020. 

I like the fact that it is consultant-lead, meaning that the doctors working here are heavily involved in the decisions made within the clinic. The facilities are also fantastic for the patients.

Prof Dame Regan: I started working at OneWelbeck in January 2021, bringing my gynaecology clinic over from St Mary’s Hospital and the London Wing. 

I was attracted by the idea of having high-quality services for all aspects of women’s health located in the same place. 

The location and the layout of the sixth floor is very attractive and welcoming. The women’s health services are located on the sixth floor and breast screening services are co-located with gynaecology. 

Gynaecology is not just a single specialty: it includes many different areas of specialist expertise, contraception, menstrual period problems, cervical screening, early pregnancy, menopause, urogynaecology, gynae cancers screening and treatment and so on.

My dream was that instead of women having to attend three to four different appointments to go through simple services to keep them fit and healthy, that they could access them all in the same place and at the same time. 

How does working at OneWelbeck differ from your previous private practice experience?

Prof Setterfield: The facility is modern with a spacious feel. There is a relaxed yet efficient environment that ensures patients have a good experience throughout. 

The entire team is carefully selected, and each is looked after so that staff are happy in their work and are able to provide the best care for patients. 

Prof Sandhu: The main difference is that this is a clinical partnership. Our group’s ‘mission statement’ was to bring together clinicians who were world leaders in their fields or the ‘rising stars’ of the future and colleagues you would be happy to have as friends. 

There was also the promise of a high-tech clinic within a luxurious environment, which has been delivered beyond expectations. 

Dr Beach: Here I have the flexibility to see patients outside of my normal clinic hours, meaning we can offer flexibility to our patients.

Prof Dame Regan: As I mentioned before, having all women’s health services in one place makes a huge difference. 

Also, the different floors at OneWelbeck house many other specialties that so many of my female patients would also like to access; for example, digestive health, heart health, hormone and skin health. 

I love the idea that I can ring up colleagues on another floor specialising in other areas of medicine and get excellent advice for my ladies. 

It also works the other way round: I often receive calls or texts from other floors asking ‘who is the best person to send this lady who has xxx problem to for advice?’.

The investors model means that it encourages collaboration instead of competition. 

It is good for my practice if the women you send to see me get the best advice. 

And if I decide that I am not the best person to give it to them, then it is in my best interests to refer them on to someone who has more expertise in that area of women’s health.

Is it more fulfilling professionally?

Prof Setterfield: Yes, every aspect of our dermatology service has been carefully planned to ensure a streamlined highly professional service. 

Prof Sandhu: Being a ‘share-holder’, you have a feeling of ownership and, as a result, you are all invested in the success of the clinic. You have a say in nearly all decisions. Any growth or success is yours to celebrate.

Dr Beach: Yes, I love working here, and I know that my patients always have a positive experience which, in turn, makes my job that much more satisfying.

Prof Dame Regan: Definitely, because at the end of a clinic I really feel that the patients have had a pleasant experience, received first-rate advice and may even have undergone a procedure during their visit – a real one stop shop.

What do you particularly enjoy about it?

Prof Setterfield: As the lead clinician, I have particularly enjoyed planning a bespoke dermatology clinic with the very best facility, the most modern equipment, including a unique 3D artificial intelligence-equipped mole-mapping service and, most importantly, inviting some of the best dermatologists in London to join the group. 

We have, to date, 22 of the top London dermatologists, plastic surgeons and allergists in London. This is unrivalled and singles us out as the leading private dermatology clinic. We are centrally located and so are accessible to much of London

Prof Sandhu: I walk into the clinic and there is a relaxed environment and you are clearly walking into a medical facility that belongs in the 21st century. 

The staff are polite and welcoming and there is very much a ‘can do’ work ethic. You know that you have had a hand in creating this. 

Dr Beach: Having consultants from other specialties around – such as pain management, radiology and rheumatology – and others – so that we can bounce ideas off each other.

Prof Dame Regan: Friendly staff, lovely surroundings, proximity to other experts, diagnostics and imaging facilities.

How does the business model enable innovation?

Prof Setterfield: As partners in the organisation, we are able to influence any decision regarding our service, provide evidence for new innovation and ensure that we remain the leading dermatology centre in London.

Prof Sandhu: The consultants are basically equal owners in the clinics. This means that we have equal responsibility for all expenditure and earnings. The partnership can come up with ideas and innovations and propose them at one of the regular meetings with management. 

Neither side is financially motivated to push wasteful ideas. To date, nothing that we have proposed has been rejected, but sometimes we have been advised about the practical difficulties of a proposal and provided alternative solutions. 

Dr Beach: Having a financial stake in the business means that we are key decision-makers, so we get to influence what happens in the centre, and particularly the treatments we offer. 

This means we can be at the forefront of medical innovation and ensure our patients can access the latest technology.

Prof Dame Regan: Everyone is incentivised to get the best services for their patients rather than competing to see everyone themselves. Fees for scans and blood tests go into the communal pot.

OneWelbeck promotes the aim of ‘empowered doctors’. How does this work in practice?

Prof Setterfield: By being in a partnership, the doctors can ensure that every aspect of our service is optimised and kept up to date. 

We have been able to invite the colleagues that we know provide excellent care both in the NHS and private sector and many of us are also highly academic leaders in our respective fields.

Prof Sandhu: I do feel empowered at OneWelbeck. I have a say in the running of my medical practice and, as a group, we can agree the direction and growth of the clinic for the benefit of patients.

As a novel model of decision-making, when we started, we had concerns that we would be dictated to as in many other private clinics. This has never happened.

Dr Beach: Personally, I am a member of the commercial team which helps decide the direction that we want the clinic floor to go to.

Rather than simply being told about what is happening with our commercial strategy, I can influence how our budget is spent on areas such as marketing and events. This wouldn’t happen in a standardly operated practice.

Prof Dame Regan: It is great to be able to reach out to other specialties and ask for advice and recommendations about which doctor or treatment would be best. 

I often receive queries from other specialties at OneWelbeck and I may say ‘I can happily see your lady’ or I might say ‘I think the best person to see her will be Dr X’ and give them the contact details.

What is the ‘new model of excellence’ you aim to provide to referrers and patients?

Prof Setterfield: The new model of excellence ensures that patients are looked after by the best person for their specific problem. Initial triaging of referrals as well as cross referrals between consultants is standard practice. 

As we have ensured that the full range of expertise is available, patients should feel confident that they are being looked after by the right person.

Prof Sandhu: By any measure, within OneWelbeck ENT, we have doctors and allied health professionals who are leaders in their respective areas of interest, most of them internationally respected. 

The partnership will aim to direct patients to the doctor best qualified to manage their condition. 

Patients will be seen in a comfortable and friendly environment using equipment that provides the highest standards for investigations and treatments. 

The clinic will always be competitive with its fees for both self-payers and insured patients.

Dr Beach: Quite often within the world of sports medicine, a patient will need to travel to different locations to see various specialists and for scans and X-rays. 

With the OneWelbeck model, we streamline the number of appointments a patient needs, minimising stress and enabling them to see the specialists they need as quickly as possible, which speeds up the recovery journey.

Prof Dame Regan: Women’s health has never been given the prioritisation it needs and women have been disadvantaged by the bureaucracy of our NHS and private health services for decades. 

This is an opportunity to really offer women the services and the maintenance care they need to remain fit, healthy and productive throughout their life course.

In the past, we have tended to wait for women to develop a problem and then try to treat it. That is not good medicine and it is also more expensive. When we do better for women, everyone benefits and we can provide better care for less money.

Did you ever feel isolated in previous private practice? If so, has that changed now?

Prof Setterfield: Yes, this was one of the limitations of private practice elsewhere compared with working in a team as for example in the NHS. 

At OneWelbeck, we have the benefit of working within a great team but with the advantage of having developed a highly efficient and innovative centre. We would all be happy for any of us to look after our families and friends

Prof Sandhu: As a ‘sole operator’, you do sometimes feel isolated in private practice. 

Working in a partnership with friendly and talented colleagues removes any such isolation. There is always someone with whom to have a friendly chat or exchange ideas.

Dr Beach: I never felt isolated, as I previously worked in a physio/osteo-based practice; however, it is nice to work more closely with other sports medicine and orthopaedic consultants.

Prof Dame Regan: This is a very collaborative model of practice –there is always someone around to ask for advice or to share an unusual case with and to learn from. 

I regularly ask colleagues from other specialties to give me a quick tutorial or catch-up summary about a problem that I may not see very often and want to ensure I have the best knowledge for the future.

How do you see the future of OneWelbeck evolving in five years’ time?

Prof Setterfield: I foresee the future of OneWelbeck as going from strength to strength both within London with plans to expand further to include the full range of clinical expertise, as well as nationally and internationally. 

Prof Sandhu: OneWelbeck will continue to grow both in London, nationally and beyond. The delivery of medical care is clinician-lead and, for this reason, I believe it will remain at the forefront of innovation in healthcare for the benefit of the patient.

Dr Beach: My aim is for us to be the go-to destination for patients with MSK issues, with world-class imaging and consultants working collaboratively.

Prof Dame Regan: I very much hope that the Women’s Health model will become the norm – one-stop clinics providing women with excellent, swift care and a signpost to other experts that they may need now or in the future.

• See ‘Business is on the up’