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Secret Diary of a Practice Manager – Election 2019

The election is right around the corner and unsurprisingly the NHS is figuring prominently. Each party has its own answers to the problems within the health service, and numerous proposals have been made hoping to get our vote.


Talk is cheap but action is defining. Whether we believe the NHS is being privatised by the back door or not is almost incidental, as some of the root problems we face will never be discussed for fear of alienating voters.


Keeping patients’ expectations in check

In the past 12 months I have experienced the NHS in action on several occasions as a patient and received first- rate care each time. However, on each occasion I have noted the underlying issues which we never see discussed or tackled.

Having broken my foot last year I ended up in A&E and, following a scan, had to wait a number of hours to be seen by the doctor. The unit was busy and people were moaning and getting abusive, some walking out due to the long wait.

When I was seen the doctor apologised and noted how patient I had been when others were not. Of course, I told him, I work in the NHS and realise the issues of delay - I was happy to wait.

Sadly this is not the case with many people, many of whom think they should receive instant attention. I’ve also witnessed patients arguing with NHS staff in an A&E department and at an OOH centre recently. 


Tackling the difficult issues is vital for the NHS

How we overcome any of these major problems is paramount to the running of the NHS, but there is a fear in tackling these issues as it alienates patients.

Many of them are made aware of what they can expect from the NHS and are happy to moan when things do not go as they think they should - but there is little talk about what is expected of patients’ behaviour.

When I was recently booked in for a small procedure, I was given the chance to cancel the appointment by phone if I didn’t want to proceed or needed to change the date.

When I attended, I was speaking to one of the nurses who took me on early as a number of patients had not shown up. This is quite a regular occurrence, I was told, and as a result it increases costs and makes the waiting lists even longer for others.


Educating the public about changes to Primary Care

We need a positive dialogue both ways, with the honest truth being spoken. Recently there was an announcement in one of the health journals that in the first six months of this year, 2.5 million more GP appointments were made.

This did not get a lot of coverage on the general news and so the public remain none the wiser about why waiting times to get an appointment are getting even longer.

The government is happy to upset the NHS and its workers by laying blame on them, but will not give the public a true picture of the demand on the system. People need to have a better understanding of how they can contribute to remedying some of the wastage within the system.

The NHS is also promoting the use of Physician Associates, Pharmacists and Nurse Practitioners to address the severe shortage of trained staff, but they are not presenting these roles to the public as the changing face of the NHS. This often means that when patients are offered appointments with these new staff they turn them down, as in their mind this is second-best to seeing a GP.


What does the future hold?

As I have said before in many of my blogs, we have a great NHS. However, it will continue to struggle without more realistic demands being placed on us, a better level of public education and a process to change the mindset of what the public expects.

I am not holding out much hope that any one party will take on the challenges above, and lay it out as it really is. The problems are complex and no single remedy will put it right, but being honest and open with the public may just bring them on board to do their bit to keep the NHS running smoothly.


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