Life as a GP Practice Manager

Chat about anything you like... Fed up with the state of the world today? Tell us!
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Janey Dal
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Re: Life as a GP Practice Manager

Post by Janey Dal » Sun Jul 09, 2017 10:35 am

Get a grip Stuart! The NHS hasn't time to deal with patients! There's too much paperwork to do!

Mike it's not the system that needs switching off, it's the eejit who wrote the software. And talking of money - it will have cost quite a lot to produce the software that doesn't work.

Mind I remember when I was made redundant a few years ago. Alan was on ESA and I was obviously claiming Job Seeker's Allowance. I spoke to the DWP because Alan's payment was late and apparently their new software couldn't cope with having two people living at the same address on different benefits so Alan's was being done manually. :shock: :shock: :shock: .

Can you imagine how many millions of pounds had been spent on developing that? Anything where the government is involved is pathetic!

Hugs

Jane xx

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maz
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Re: Life as a GP Practice Manager

Post by maz » Fri Aug 11, 2017 2:20 pm

I want to thank you for sharing as much as you feel able to Jane. It is interesting to see things from the other side, and know what is going on behind the GP's closed doors.
Marilyn

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stuart13
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Re: Life as a GP Practice Manager

Post by stuart13 » Fri Aug 11, 2017 5:58 pm

Today I attended a NICE meeting down in the big city and I had one of my 'little' outbursts, I'm getting a bit of a reputation.

I am concerned that we are doing a great deal of work reviewing documents and coming up with recommendations, but this is my gripe, they are just recommendations and although they keep trying to reassure me that it carries weight, the recommendations are not mandatory. According to the remit, NICE makes them as being 'Best Practice'.

No teeth.

Stu :)

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MikeyB
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Re: Life as a GP Practice Manager

Post by MikeyB » Fri Aug 11, 2017 9:08 pm

I wish more people knew that. Their recommendation that T2 diabetics are not routinely issued with blood testing kit, and strips, is being taken as a law written in stone by the CCGs.

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Janey Dal
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Re: Life as a GP Practice Manager

Post by Janey Dal » Sat Aug 12, 2017 12:31 pm

Oh Stuart! You are so right! And I think if you are going to get a reputation for making a fuss then go for it my friend! The NHS needs people like you.

NICE guidelines are exactly as you say -ie best practice. Good GP practices will adhere to them as far as possible (some aren't perfect) but I suspect there are a lot of GP practices that don't bother.

The only time this would matter is if a patient decided to put in a complaint. It could well go to court if the patient wants to go that far and it wouldn't look good on the practice/GP. But as you say,if they are only guidelines and not mandated, it may result in a slap on the wrist, but no more.

Sadly as Mike says, the CCGs pick their weapons and try to enforce them. But the CCGs are as toothless as the NICE guidelines.

The CQC is the only organisation that has any real clout with GP Practices. But equally the CQC is frustrating!

We had our CQC visit in October last year. We scored a 'Good'. There are only 4 ratings: Outstanding,Good, Requires improvement or Inadequate.

It is a well known fact that it is nigh-on impossible to get Outstanding. So most GP practices get a Good. However, some will be at the top of that rating and some will be borderline 'Needs Improvement".

So the Good rating means very little in terms of how 'good'. I have been through 2 CQC inspections in my career within the last 2 years. One practice was not good at all but managed to scrape a Good rating. My current practice is far, far better, but still only received a Good rating.

And as a practice we have to pay for this!

Sadly the bureaucracy within the NHS is eye-watering. At least as a GP practice we have some autonomy on what we choose to adopt, but that's only good if you are a good GP practice.

The dubious ones will manage to avoid all the 'good practice' advice and carry on practicing because the 'authorities' are not working together and have no idea what is actually going on.

Hugs

Jane xx

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Foxysally
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Re: Life as a GP Practice Manager

Post by Foxysally » Thu Aug 17, 2017 1:40 pm

This is one of the main reasons I left full time teaching to work from home instead. We were subjected to new initiative after new initiative, each one reinventing the wheel over and over again and none of them ever staying in place for long enough to find out whether or not they actually made a difference. Every new government or education minister would chuck out all the old stuff and start all over again. The beaurocracy surrounding this was unbelievable and must have cost an eye watering amount of money. You would have to go along with whatever the new thing was, go on training days, change the way you did everything, write all new policies and get them approved by some bod at the council, for it all to be scrapped a year down the line in the face of some new and "better" way of doing things.

The children didn't benefit from any of this. It would be far better for the children and cost a fraction of the price if they just left teachers to get on and teach. I'd go back into the classroom in a heartbeat (health allowing) if I didn't feel I was a puppet on a string for the government. It sounds as though the NHS is just the same. I'm not at all surprised reading your posts.

Sorry, that was a long rant!
Sarah

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Anne Dawson
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Re: Life as a GP Practice Manager

Post by Anne Dawson » Thu Aug 17, 2017 3:45 pm

Sarah - " Like!"

Action plans - how many new action plans have I written in my life?

I regularly meet some retired teacher friends and we all look so much better now we're not working - even me without my pancreas!

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paul.m
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Re: Life as a GP Practice Manager

Post by paul.m » Fri Aug 18, 2017 6:33 am

When my daughter was at school before they started writing on a new sheet of paper they had to do patterns around edge . As my daughter was getting a bit behind on her work at parents evening I asked why not do work first .Teachers reply " It makes the work look pretty "
We used to have a saying at work
" If it ain't broke don't fix it "
Paul

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Janey Dal
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Re: Life as a GP Practice Manager

Post by Janey Dal » Sat Aug 19, 2017 2:15 pm

My daughter is a teacher and we often discuss the similarities between the NHS and teaching.

The main theme is that both are government run! So we all spend our time providing stats that mean nothing so that the government can make decisions based on stats that, well, don't mean anything!

There is a mind set around payment by results in government. I feel that I am sounding like a broken record at times because my personal irritation is around strategic decisions that don't work at operational level.

We can all tick boxes to say we are doing what is expected. But who is overseeing that we are actually doing it?

We have the CQC and Ofsted. But they will never be able to actually decide who is really doing the work and who is just box-ticking.

We have policies aplenty in my GP practice and I regularly review them to ensure that they are a) fit for purpose b) honest c) doable.

But I suspect that many GP practices have policies that 'say' the right thing, but that are never even reviewed or adhered to.

Hugs

Jane xxx

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Janey Dal
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Re: Life as a GP Practice Manager

Post by Janey Dal » Sun Aug 20, 2017 11:36 am

Just as an addendum to this: my daughter has wanted to be a teacher for as long as I can remember.

For various reasons it took her until she was 28 to be able to start the PGCE course. This was after being offered a bursary by the government for 24 grand per year, untaxed!

Very nice - it was legal and genuine. After her first year she was so disillusioned by the workload she seriously considered leaving. And believe me she isn't a shirker, she's always been a hard worker.

The main reason she has stayed is that she is hoping to buy a house and needs the income. She worked around 75 hours per week in her first year and the salary is less than the bursary. And I am sure people will say that they get loads of holidays,but she worked through many of her holidays as well.

So I can see a pattern here: in order for her to have any kind of work/life balance she will have to not be so diligent. And I dare say that that is what many teachers have to do.

So who suffers? Welll the pupils obviously, but if the workload is untenable what does the government expect?

One of my daughter's friends received a similar bursary 4 years ago and has now left teaching because she couldn't handle the stress and workload.

What a waste of public money! Pay university graduates to go into teaching and then watch them leave because it isn't doable!

So the money wasted within the education system and the NHS is just enough to make me want to weep.

Oh and in a further rant. I am told that the number of medical school places equals the demand. However, many doctors who have completed their training then go abroad because they don't want to work in the NHS.

Sorry! It just angers me.

Hugs

Jane xx

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MikeyB
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Re: Life as a GP Practice Manager

Post by MikeyB » Mon Aug 21, 2017 7:07 pm

Education is a devolved service in Scotland so I can't really comment. So is the NHS, but the reason for doctors leaving can be expressed in two words. Jeremy Hunt.

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stuart13
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Re: Life as a GP Practice Manager

Post by stuart13 » Tue Aug 22, 2017 8:50 am

Education and health are albatrosses that are regrettably used as political footballs

The school environment is not suitable for some older pupils who become bored and develop behavioral issues and this coupled with an inability to chastise pupils must cause a lot of stress for teachers.

Doctors who leave the NHS to work abroad after their training should be made to repay a percentage of the cost incurred in their training. There should be an obligation to work a minimum period in the NHS. The more doctors that leave puts greater pressure on those that remain.

Both areas struggle with poor managers and decision-makers.

:evil: :wink:

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maz
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Re: Life as a GP Practice Manager

Post by maz » Tue Aug 22, 2017 10:14 am

I think we could take over the running of the NHS for a lot less money. We would soon have it knocked into shape.
Marilyn

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stuart13
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Re: Life as a GP Practice Manager

Post by stuart13 » Tue Aug 22, 2017 12:07 pm

I second that.

:)

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