The Secret Diary of a Practice Manager Part 16

Things are changing, but are they for the better? We are all well aware that you can’t go a day without the press or a politician making a remark about GPs being part of the NHS problem and that more changes are needed to make it work.

So we are told we should be working 8:00 till 8:00pm and open weekends too. We must give all over-75’s a named doctor and work towards reducing admissions to hospitals by producing care plans for our most vulnerable patients. We should work together as practices offering specialist services to reduce costs and keep services in primary care.

Has any of this been really thought out or is it election jockeying by politicians to give the public what they think they want?

Of course that is on top of all the other work that has been passed on to primary care.

Let me give you a few examples and see whether you agree or not, proving that great ideas may not work in reality.

After mixing with managers at a number of meetings over the last few weeks, I realised that either I have lost the plot or politicians have not got a clue!!!

Patients are not daft they seize on any opportunity to quote the latest initiative, statistic or news bite to cause havoc.

Named Doctors

One manager was telling me after having sent out notifications of the named doctor for their over 75s,that they got a phone call from one patient asking for the doctors personal mobile number in case they needed to contact him in the middle of the night! Nothing would convince this person that 24 hours did not mean by the one doctor.

I have heard of patients going into practices demanding to see no one but a certain doctor and when told they were not on duty ,or even on holiday, they complained, as they thought they were entitled to see the named doctor as and when they needed and no else would do!

The Great Communicator

We all thought that when the PCTs were abolished the CCG would be far better and we would all be part of the commissioning process and have more say in our local services.

Has it worked out like that?

Sadly not. In our area there is very little communication from the CCG and we seem to have been consulted less and less as time goes on.

I went to a group meeting a couple of weeks ago and we were asked to do some exercises highlighting our individual views of our CCG and what they had done so far  so they could improve where necessary. The mere fact that they proposed such an exercise should highlight to them that things are not right.

Oh dear what an own goal! There were some scathing comments by others highlighting the lack of communication and lack of joined up thinking. Some were even unsure who was leading the CCG.

Let’s face it (again) there is a very big difference between ideals and realities.  Does anyone in the Department of Health or even politicians have any idea as to what goes on, and on a day-to-day basis? I doubt it.

Sharing isn’t Caring

Take another initiative that we should share services.  So one practice may concentrate on Asthma, and another would concentrate on Diabetes. Patients would be expected to go to different surgeries for different treatment. The rationale behind this is that we utilise services and staff more appropriately.

Again, sounds a great idea, but what about the continuity of care? Patients like the surgery ‘feel’ and whilst coming for a check up they can discuss other issues. They trust the practice nurse that they know. Has anyone thought of how the patients will get to the different surgeries or the fact that this would be confusing to the elderly? No I bet not!

Final Thought...

I heard an interesting comment from another CCG, meeting whenever a subject was raised for discussion, a number of people had to declare an interest and leave the room during those discussions. This will only get more prevalent as we

Commission more and more services. I predict not before long we will be back to PCT style where there would be no clashes of interest.

So have things improved for the better? I will leave it for you to decide.


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Closing Date: 3 June 2020

Salary: In line with Whitley scale 7

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