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Secret Diary of a Practice Manager - December in Review

I first started writing this 2 weeks ago, and such is the pace of change, this is now a rewrite of a rewrite.

The last couple of weeks finds us in the early stages of another variant of Covid spreading across the world, with another codeword for us to learn. Right now, we are not certain how this one will react to the current vaccines we have on the field of play, but - as we always seem to be doing - adapt and change is the current strategy of choice. Government restrictions have now changed twice, with the reimposing of masks, the use of Covid passes, and where possible for people to work from home, all in an attempt to hopefully slow down the spread of the virus.

This is still worrying; although some think these measures have been taken to distract from the government’s woes, I am not so sure - listening to all the experts they seem generally worried about this development, and I wonder if they know more than they are letting on? It’s still early days right now, but the developing story will no doubt change as time passes.

Vaccinate before you QOF-inate?

In an earlier blog, I wondered if the low uptake of the booster vaccines was due to most GP practices opting out due to the insistence that QOF would go ahead in full and so the sheer volume of work was impossible to handle.

The realisation that many Covid sites had closed and with the slow rate of rollout, the NHS decided to offer sweeteners to try and tempt primary care back into the programme; the first offer of not needing to do health checks and minor surgery was underwhelming. It freed up very little time and so was rejected.

We were then offered parts of QOF to be stopped if we signed up by Wednesday 8th December – again, after careful consideration, we had mixed views but overall, not tempted. Yet again, the deadline was moved to Friday 10th December, but this time with guaranteed income protection over QOF. Our PCN considered it carefully and after weighing up the pros and cons has now signed up.

My point here is that we shouldn’t have been put in this position - the vaccine rollout could have continued throughout the year within Primary Care and, just maybe, we could have got more people protected. Valuable time has been wasted in getting to this point which could have been done earlier and avoided a long-drawn-out process.

One thing to watch out for though is the press and media, they may have another attack on us claiming we have ditched general healthcare for the money of the vaccines and have held the NHS to ransom. This we did not do. We are all independent businesses and have to make money, which is a  fact of life.

Our Call to Action – Government Inquiry into the future of General Practice

MPs have begun an inquiry into the future of the NHS and general practice, with former Health Secretary Jeremy Hunt leading it.

My opinion? Let me start by saying that having been a Practice Manager for a very long time now (and that’s not measured in dog years), I’ve seen these issues in primary care and the NHS first-hand. I came to the NHS from a business background and was taken aback by the volume of work that goes on behind GP doors. All the letters, appointments, referrals, visits, along with the regulations and the day-to-day running of what is an independent business. This is something the public at large just doesn’t see, and the media narrative from the likes of the Daily Fail perpetuates this.

What worries me is that the NHS seems to be run on theory – civil servants advise the Health Department, who advise the Government, and decisions are made by those who have little or no comprehension of the reality of how we in primary care work.

Have they spent time in surgeries? I bet they have not. Representations by the BMA, LMC, RCPCC to the NHS are again sought, but I am not convinced our illustrious leaders will consider us seriously. We in Primary Care have the initial contact with most patients, and yet as surgeries and practice managers, we feel undervalued and made the scapegoat for the problems of the NHS.

For example, the Government hasn’t denied media comments during Covid that surgeries have been fully closed, avoiding patients, and that we are all lazy and uncaring. This has angered so many and caused irreparable damage. as it is so far from the truth and has affected morale. We have all been and continue to work harder than ever, and under very difficult circumstances.

The last two weeks have been typical in how the NHS work. They make a request that we add the Covid Booster Vaccination to our already overstretched workload for little or no release of some of the daily work and no extra income and then bit by bit offer more concessions until the offer is realistic and then we sign up.

“Oh, by the way…” – Variant Boosters ‘plan’

As I am literally about to finish writing this, the Prime Minister has just come on TV (Sunday evening) to share his plan with the nation for rolling out boosters to the whole country. A quick glance at social media, and I can see a flurry of posts from GPs, NHS workers, practices, and LMCs around the country basically saying “honestly, we know about as much as you right now”…!

Stay safe, stay sane, see you on the other side - Wishing everyone a Merry Christmas and a Happy New Year.


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