How Magdalen Medical Practice Reclaimed Capacity, Reduced Staff Costs, and Put the Joy Back Into General Practice

Background

Dr Martin Falkingham is a GP partner and Clinical Director at Magdalen Medical Practice, a nine-partner NHS practice in north Norwich. Tracey Clarke is the Practice Business Manager, responsible for operations, staffing, and the day-to-day running of a team that includes mental health therapists, physiotherapists, care coordinators, and a full nursing complement. Between them, they cover the clinical and operational heartbeat of the practice.

Magdalen runs entirely on its partnership model. There are no salaried GPs, no locums. Every efficiency gained or lost lands directly on the partners' shoulders. It also means that when something works, the whole practice feels it.

Before Heidi: The Weight of Documentation

Like most NHS practices, Magdalen's clinicians were spending significant time after consultations writing up notes, drafting referral letters, and managing the administrative trail that follows every patient encounter. For Martin, a difficult or lengthy consultation might mean 25 minutes with the patient, and then the prospect of another stretch of documentation afterwards.

“A difficult consultation, a long consultation — previously, you were thinking: Gosh, this is going to take me another 10, 15 minutes to write up.” — Dr Martin Falkingham, GP Partner & Clinical Director

The knock-on effect was predictable. Martin was routinely running behind. Lunch breaks were non-existent. And on the secretarial side, the team were spending their days with headphones in, transcribing dictated referral letters. As Martin put it, it was "1950s style with the earphones in and typing."

The referral process itself was slow and layered. A GP would dictate a letter, send it to the secretaries to type up, receive it back for checking, correct any spelling or transcription errors, and return it for dispatch. Every referral involved multiple handoffs, and every handoff added delay for the patient.

Discovering Heidi

Magdalen came to Heidi as a pilot practice. Martin began using it even before the practice had formally approved ambient listening in consultations, initially dictating notes after each patient left the room and feeding them straight into the record. From that very first use, something shifted.

“From that moment, I haven't particularly run behind. Traditionally I run behind because I was typing. That's gone.”— Dr Martin Falkingham

The practice has since rolled Heidi out across GPs, the prescribing nurse practitioner, and administrative functions. Tracey uses it for staff appraisals. The team are exploring its use for clinical supervision templates required by CQC. It has become embedded in the practice's daily operations rather than sitting as an optional extra.

The Secretarial Transformation

One of the most striking changes at Magdalen has been what happened to the secretarial team. Before Heidi, two or three secretaries would be typing dictated letters at any given time. Now, that's almost entirely gone.

With GPs generating their own referral letters through Heidi during or immediately after consultations, the secretaries' role has fundamentally shifted. Instead of typing, they're now tracing referrals, managing tasks, and doing the higher-value operational work the practice always needed but never had capacity for. Tracey gave a concrete example: secretaries are now reading and pre-populating DVLA and private health insurance reports, pulling in the latest blood pressure readings, relevant history, and background information, before handing them to the GP. Previously, there simply wasn't time.

“We haven't had to replace one of the secretaries that's left. It's been a natural reduction — we've gone, one of them wants to retire, fine. We can absorb that.”— Tracey Clarke, Practice Business Manager

This wasn't a sudden restructure. It happened organically. As Heidi took over the transcription workload, spare capacity appeared. When a secretary retired, the practice didn't need to recruit a replacement. The cost saving was real, but it came without disruption.

More Capacity, Not More Strain

With three partners due to retire over the coming 18 months, Magdalen faces the challenge every NHS practice dreads: losing experienced clinicians and absorbing their workload. In the past, that would have meant remaining partners taking on more, working longer, and feeling the strain. Martin isn't worried this time.

“I'm even going back up a session. I went down when I took on the Clinical Director role at the PCN, but I'm going back up because the things that made me want to go down sessions don't exist anymore. A big part of that is Heidi.”— Dr Martin Falkingham

Martin is clear that multiple factors are in play. His Clinical Director role is shrinking, and the practice is navigating organisational change. But the removal of administrative burden from clinical sessions is, in his words, "a big part" of why he can now increase his clinical commitment rather than reduce it. For a partnership model practice facing retirements, that kind of retained capacity matters.

Faster Referrals, Fewer Handoffs

The referral workflow has been completely streamlined. Martin now writes referral letters during clinic using Heidi, sends them directly, and sees them returned to the patient record by the end of the session. The old process, with its multiple rounds of dictation, typing, checking, and dispatch, is gone.

“I used to take quite a lot of pride in making sure my referral letters sound good and professional. Now I can just blurt it out and Heidi will make sense of it all. And it's back from the secretaries, in the notes, in the journal, by the end of the clinic.”— Dr Martin Falkingham

For patients, this means referrals are processed on the same day rather than sitting in a queue. For the practice, it means fewer outstanding tasks, fewer opportunities for things to fall through the cracks, and a cleaner audit trail.

Beyond the Scribe: Appraisals, Supervision, and Team Use

What sets Magdalen apart is the breadth of adoption. Tracey uses Heidi for staff appraisals, a function that every NHS practice is required to complete annually for every member of staff, and one that typically involves hours of scribbled notes and subsequent write-up.

“When I'm doing staff appraisals now, I'm more engaged with them instead of scribbling loads of notes. I just say at the beginning, are you happy for me to record this? And we can actually enjoy the conversation.”— Tracey Clarke

The practice is now working with Heidi to build a clinical supervision template for CQC compliance, converting a regulatory requirement from a documentation burden into a conversation captured automatically. The prescribing nurse practitioner uses Heidi for same-day patient consultations and has reported significant time savings.

Where It's Still Developing

The team is open about the fact that Heidi isn't perfect in every context. The prescribing nurse practitioner has found that she needs to double-check consultations because the tool doesn't always pick up anatomical terms correctly, particularly left and right distinctions. She knows to review the output, and does so routinely, but it's worth noting for anyone considering adoption: clinical checking remains essential.

For the nursing team more broadly, Heidi's value is currently limited to dialogue-based consultations. Much of their work sits inside structured Ardens templates within SystmOne, and until Heidi can populate those templates directly, the nurses can't benefit in the same way the GPs do. This is something the whole practice is keen to see develop.

Looking ahead

The practice's most anticipated next step is integration with SystmOne, the clinical record system that sits at the centre of their daily workflow. Martin sees this as the point where Heidi moves from a powerful standalone tool to something woven into the fabric of the clinical record. The team is also interested in Heidi's potential to auto-populate structured Ardens templates, which would unlock significant time savings for the nursing team running long-term condition reviews.

Tracey has a more operational ambition. The practice currently maintains a manual spreadsheet logging every referral by department and specialty. She'd like to see Heidi capture and group referral data automatically, removing another layer of manual tracking from the secretarial workload.

Looking ahead

“I've recommended it to my wife's practice and they're all using it now.”— Dr Martin Falkingham

Martin's endorsement extends beyond family. On a GP training WhatsApp group, he polled colleagues on ambient AI. The responses were unanimous: everyone was using Heidi. No other tool was mentioned.

Tracey recommends it just as readily to her practice manager and admin network, recognising that Heidi's impact isn't limited to the clinical consultation. It touches operations, staffing, compliance, and workforce planning.

“I'm having lunch now. I never used to have lunch.”— Dr Martin Falkingham