Ok after a weekend of frustration I may have solved it, by using the Nvidia inspector and selecting the following parameters and more specifically with the one highlighted below:
Went for several solo flights in numerous aircraft types using the Slovakia summer map with everything maxed out and with lots of clouds (even had forest set to 4 in a read only conf. ini) and it would appear thus far that I'm stutter and tear free, still need to see what happens when the sky is a tad more busy but thus far things seem to be OK.