Secret Diary of a Practice Manager - The State of the Nation...

Our anonymous blogger is back and they have a lot to get off their mind! They take aim at the approach taken by Jeremy Hunt and the Government to managing CCGs and general practice, as well as discussing the tough decisions currently facing many practice managers.

So Jeremy Hunt, the captain of the 'NHS Titanic', thinks the NHS was essentially created by the Conservatives! This laughable claim was made recently at the party’s recent conference in Manchester.

Whilst there seems to be a lot going on politically, very little is being said publicly about the NHS and this is when we should be very wary of its agenda. Our local CCG, which is struggling financially but not in terms of delivering care and attention, has been very open with the issues that they - and we - are facing.

In the past, there has always been the feeling that at the end of the day we will muddle through with more money being found and even where care may need to be reduced, patients' best interests would always remain the priority.

The feeling I am getting now though is that those days are over and that Jeremy Hunt has told Simon Stevens and the CCGs that this winter the NHS will not tolerate patients being kept in corridors on trolleys or queuing ambulances being spotted outside A&E.

Word is that the government and Jeremy Hunt are bankrupt of ideas about how to solve the crisis and are passing the buck to CCGs. I have reported that I consider our CCG to be very good - they are trying their hardest to make ends meet and yet we are many millions overspent.

I attended some recent meetings where difficult decisions were made on what procedures and medications would be cut, just to reduce the overspend a little. Not easy decisions and the choices are of course very stark.

A patient told their hip operation is cancelled or delayed runs the risk of costing the NHS more in the long term, as a fall or incident could mean more complicated surgery and aftercare than the original operation.

I’m sure these choices and discussions sure are going on right across the country and often agonising decisions are having to be made.

In trying to write a balanced article I must raise the issue of how much is being spent by CCGs themselves to supply practices with toolkits that are probably costly, and ones we have either purchased ourselves, or ones that we just do not need.

For example, we have a particular document management system, and our CCG are considering offering it to all practices at a reduced rate - why?

We are being provided with toolkits to supposedly help us with our appointment planning. How that can work is beyond me, the toolkit can no more predict demand than we do already and indeed we already build capacity into our appointments system. So why?

CCGs are trialling (who knows at what cost) a system where patients email in their symptoms and get a response from the GP. It has been trialled by few surgeries so far, but it has not taken off and I am not surprised. Any good GP would be unwilling to diagnose without seeing the patient, and would any patient really want to be treated in this way? Money spent… money wasted!

In my view you become morally bankrupt when you try to keep your head down and pass the buck to the CCGs, hospitals and GP practices to sort out the complex issues. I certainly do not have all the answers to the crisis but we cannot go on in this way.

The party or government that takes up the gauntlet to look at all these issues openly, to try and find a solution and enter a dialogue with the people will attract the popular vote but more importantly it will save the NHS from further cuts to the services that the people want and need.

As I have said in previous articles the public are willing to pay more tax to get the NHS they cherish, so governments must not avoid their responsibility to look after the people of the country.


Andrea Simpson 18/10/2017

Well said, this Government are starving the NHS of funds and disenfranchising the staff as well. They are making it harder for us to recruit with nurses bursaries being scrapped and their solution is to criticise general practice using the right wing media. We are at breaking point with little left at our disposal to aid the system. The system is broken and in need of a realistic conversation about more money into the NHS with the electorate. What we need is rid of the bureaucracy of 3rd appointments and toolkits and some real tangible changes to how we deliver healthcare as a whole system.

Paul Smith 18/10/2017

Spot on - you have described exactly how I am feeling just now. The appointment thing is laughable I dug out my 2007 3rd available appt file (think I will just feed them those details nothing much has changed) It seems like the juniors are now in charge wherever and they are remembering the trauma and confrontation (or was that just me) so they are now in charge and are making their 'juniors' ring all the practices (and see how they like it)

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