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Life as a GP practice manager

Posted: Sat Jul 06, 2019 11:25 am
by Janey Dal
Yes you thought you’d got rid of this didn’t you! :lol:

The irritating thing for me personally is that I have ambitions to write a book when I’m retired on life as a practice manager and was going to use the previous thread to remind me of all the things that occurred :evil: . Hey ho! Nobody died!

This week I have decided to write a letter of complaint to the GP practice where my mum is registered. It used to be a good practice (she’s been there for 50 years) but with the change in personnel over the years it has really gone down the pan. I, of course, would find it difficult to complain given my job, so have decided to write under my maiden name which is the same as mum’s obviously and thereby swerve any professional conflicts that using my married name would cause.

I have got mum registered at a different practice in the meantime.

It’s a strange world as there is regular local practice managers’ meeting so we all know each other, we all have similar issues in terms of demand and changes mandated by NHS England. However, for the managers living in the area (most of them) we will all be registered at one of the practices whose manager we know well.

There is an unspoken etiquette that we never say which practice we are registered at. This may sound strange but for the practice I work at, I know for a fact that one of the other managers is registered with us - only because I have seen her in Reception attending an appointment, but I have never come across her name in the computer system in the course of my work.

When you work in the NHS in a patient-facing job you can know all sorts about people, but you never say a word.

Equally though, my best friend is registered at my practice and I have assured her that should I ever have cause to look at her record I would ask somebody else to do it for me. And I would, it’s courteous and respectful.


Jane xx

Re: Life as a GP practice manager

Posted: Sat Jul 06, 2019 12:05 pm
by maz
Oh Jane, I really am sorry it happened. I guess nothing is safe. Nasty mean hackers.

Our daughter went for her smear the other week and the nurse popped out and said 'I can't do your smear as I'm your cousin!" Our daughter didn't recognise her, not having seen her since my sisters funeral and my niece had since lost weight and gone blonde! Plus her working there was unexpected anyway. I have a friend, same age, who, back when all our kids were little, went to a male GP who was also a friend, together with his wife and only a few years older. So odd when she mentioned going for female issues. We all 6 used to have dinners together so it was often mentioned just in passing :D

Re: Life as a GP practice manager

Posted: Sun Jul 07, 2019 11:31 am
by Janey Dal
It’s weird isn’t it? The thing that makes me laugh about working with GPs is that nothing, even female problems, are off the agenda! I recently went for a hospital appointment for a gynae problem and I needed the time off work to attend so I told the senior partner all about it. He was very interested!

In my previous job with a male boss if you mentioned ‘women’s problems’ he would say “Take a week off! Take a year off! Just don't give me any details!” :lol: .

The smear story made me laugh. We had a similar situation where an external nurse was standing in for the day to do smear tests. We rang one of our patients to say if she wanted to come down for her smear we had a nurse in that day. “Yes I know” she said “but the nurse is my mother so I would prefer to see someone else!” Luckily the nurse had advised her daughter that she was working that day - or else that would have been a tad awkward! :lol: :lol:

There was a lovely story this week when a male patient came in with his wife. She reported to the doctor that he was apparently increasingly bad tempered and wondered if it was anything to do with a dog bite he had had when he was 7 :shock:.

This caused much hilarity afterwards. I suggested that if that were the cause then all men over 50 must have been bitten by a dog :lol: .

We did wonder if the patient had started to bite people and cock his leg up on the furniture.

Re: Life as a GP practice manager

Posted: Mon Jul 08, 2019 6:47 pm
by MikeyB
My last GP job before I came to my senses was as a single handed GP in the small town I grew up in. So I ended up doing intimate examinations on ladies who I knew when we were kids. I did refrain from saying “At last...” :lol:

One of my patients was a retired teacher - she taught me to read and write. When I handed her a prescription I’d just written out and signed, she took one look at it and said “You never did pay attention”.

Re: Life as a GP practice manager

Posted: Tue Jul 09, 2019 9:22 am
by maz
:lol: :lol: :lol:

Re: Life as a GP practice manager

Posted: Sat Jul 13, 2019 11:28 am
by Janey Dal
So a full moon this week! We seem to get weeks where every patient is barking mad :lol: :lol: .

I’ve had to write letters to 3 patients to advise them that they will be removed from the list if they don’t behave themselves - one was drunk and could barely walk, one swore at a receptionist and the other one was just downright rude to nurse :roll: .

I’ve had an ex-member of staff writing inappropriate comments on Facebook about a nursing home - luckily she left some time ago but I had to let the practice she’s moved to know about the comment. The nursing home are complaining about slander (with every right to do so). Luckily she hadn’t put the name of the practice on her profile otherwise that could have been a legal matter!

One of the Receptionists reported that 3 patients had said there was a man on the corner of the street slumped on the floor - nice of them to come and tell us rather than ring a bloody ambulance. My colleague and I went to see what we could do. He was under the influence of something dubious and said he was epileptic but refused to go to hospital and staggered off telling us to mind our own business! Nice to be nice! :lol: :lol:

We didn’t even know if he was one of our patients! :roll: :roll:

One patient rang to change to a different GP (we run personal lists so you have a GP who will always see you - great for continuity of care) because she ‘just wasn’t feeling it’ with her current GP :shock: .

And finally a man who rang up wanting to know the name of his 34 year old daughter’s GP and then got extremely angry when we refused to give that information out :roll: .

I tell you - you don’t half see life in a GP practice :lol: :lol:

Re: Life as a GP practice manager

Posted: Sat Jul 13, 2019 9:23 pm
by maz
I'm worn out reading about your week :shock: How do you do it?

Re: Life as a GP practice manager

Posted: Sun Jul 14, 2019 11:46 am
by Janey Dal
We laugh Marilyn! That’s what we do! If we didn’t we’d go slowly insane :lol: :lol: .

Interestingly Practice Managers rarely leave to do something different. Mainly I think because it is so varied and interesting and is continually changing so you have no chance of getting bored. I have been dong it for 3 years now and learn something new every day.

You do need a sense of humour though!

This week I have terminated the contract with the current cleaning company because the cleaners are utterly stupid and lazy and the company are not managing them. Ridiculously under employment law the cleaners have to be transferred to the new company but at least they will manage them and get rid of them if needed (or so they say).

Following an infection control audit last week I have been on at the cleaners to store the mops upside down with the mop heads at the top, not touching the walls or floor. Nice, easy instruction.

Apparently not :roll: . Despite leaving a note for them in the cleaning book, putting a massive poster on the wall of the cleaning cupboard, leaving a message with their manager and a second note in the cleaning book all over the space of a week, the mops remained resolutely head down.

Finally I got a response from them “we can’t store the mops upside down, I can’t see how to do it, could you show us?”. I read this on Friday morning, went into a proper strop because there are clips on the side of the cleaning trolley which they clip the mops to, so all they had to do was turn them upside down and slot them into the clips. How hard can it be really?

So off I went into the cleaning cupboard to investigate and they had stored the mops correctly -see what I mean about stupid?

Re: Life as a GP practice manager

Posted: Sat Jul 20, 2019 11:21 am
by Janey Dal
So things are a-changing! As ever in the NHS!

I did a management course many years ago and one of the things I learned about change is that following a change the people/organisation who have been part of the change go through a process called “Storming, forming, norming and performing”.

Sadly the NHS is permanently stuck in the ‘forming’ stage because it never manages to get to ‘performing’ before someone changes it again!

Just a heads up for you - I think I mentioned this in the previous thread - in this area our local pharmacies manage prescriptions for patients. That is, you phone your pharmacy to order your repeat medication, not your GP practice.

This will be changing (again in this area I don’t know about elsewhere) on 1st September. So if you usually order your prescriptions from your pharmacy that may no longer be an option.

Please don’t panic! You will not be left without medication BUT it may be a good idea to think about how you want to order your prescriptions in future.

Firstly, speak to your local pharmacy to ask what is happening in your area.

If they are no longer managing your prescriptions for you after September 1st you have 3 options:

1- You can drop your prescription request into your GP practice (either the right hand side part of your paper prescription or a written request)
2 - You can download the NHS app on your phone (very easy, and I am quite impressed with it personally) and this allows you to order via the app.
3 - Sign up for your practice’s on-line service which is much the same as the NHS App but you need to visit the practice to provide ID to register and if you forget your password you would need to contact the practice to get it reset.

The extra bonus of the last two options is that you can also book appointments on-line as well, thereby negating the need to ring your practice as often. Always a bonus as you can never get through in under 10 minutes!

However you may be on Repeat DISPENSING - sorry if I’m boring you but this is quite important - you would be eligible for this if your medication is pretty much the same month after month. Repeat dispensing means that your GP can sign for you to have the same repeat prescriptions for up to 12 months - if this is the case you won’t need to do anything other than turn up at your pharmacy and collect your prescriptions.


If you are unsure about this (and believe me it is bloody complicated!) then please speak to either your usual pharmacy or your GP practice. If this is not happening in your area at the moment, then believe me, it will be soon.

Sorry for a boring thread but thought you guys should know!

Re: Life as a GP practice manager

Posted: Sun Jul 21, 2019 9:19 am
by maz
Thank you Jane. Without you to explain things to everyone in the country Jane, I can see problems when these new plans come into effect :| . I don't think I have heard anything about it apart from what you have shared. Not that it affects me, but it shows the message isn't widely out there yet.

PS. You should be the official government spokesperson for NHS changes :lol: That would be one busy job :roll:

Re: Life as a GP practice manager

Posted: Sat Jul 27, 2019 1:36 pm
by Janey Dal
:lol: :lol: Not ‘alf!

So a busy week this week because I am now off for a fortnight. I need a holiday to get over prepping for the holiday!

And a frustrating situation with a patient who we removed from the list for repeated ‘did not attends’ (DNAs).

She came back and asked if she could re-register. We said yes but only because we have no bloody choice :twisted: . We are contractually not allowed to refuse any patient registration at the practice unless they are violent or aggressive. So we kick patients off the list and they have every right to come straight back on :roll: :roll: . We don’t advertise this obviously!

The only thing we can do is ask them to sign a contract to agree they will behave themselves - for all that is worth! And sure enough two weeks after she had been re-registered and signed the contract she has DNAd twice more :evil: :evil: . She has been sent a VERY strongly worded letter from me telling her she is thoughtless and her behaviour is immature but both her GP and I think this is not going to make a blind bit of difference. I did add at the end of the letter that if she DNAs again she will be kicked off again and she will not be welcomed back.

That is to say we can’t stop her re-registering but she won’t be welcome :lol: :lol: . Hopefully she will read it and assume I am saying she can’t. It’s the best I can do to discourage her and remain within our contractual obligations :roll: .

Her GP says she is utterly feckless and is in the process of having her 3 children taken away from her and apparently this is not her fault. She took her 11 year old child into her last consultation with the GP and told the GP about her desire to commit suicide and the amount of cannabis she smokes. When the GP tried to encourage her to put the child outside she said it didn’t matter because he knew all about it. :evil:

So I suspect you will understand when I say having her children removed from her care would be a very good idea.

Re: Life as a GP practice manager

Posted: Sun Jul 28, 2019 9:02 am
by maz
Do you have to have 2 weeks holiday Jane? It means I don't get my weekly chuckle about your annoying patients, learn about the workings of a GP surgery, or have a weekly annoyance at some of the ridiculousness of the NHS. Maybe the latter will be a good thing though :lol:

You do deserve a good break actually so I hope you manage to do some things just for you, and have some major relaxation time.

Re: Life as a GP practice manager

Posted: Sun Jul 28, 2019 11:55 am
by Janey Dal
Thanks Marilyn!

I am ready for the break - I know I love the job but I work bloody hard as well!

About December last year we had to have our IT router upgraded. This was a project across the whole area and was mandated by our IT providers (the CCG) but was farmed out to a 3rd party company because they don’t have the manpower to do it themselves.

It is always a concern when 3rd parties are commissioned to do work for the practices because they really have no idea how GP practices run.

The project manager from the 3rd party suppliers sent me an email and said the practice would need to have the computer system down for about an hour whilst they did the work. Now this is not an easy task as I am sure you can imagine. They couldn’t do it outside of working hours (cost I suspect!) so we were going to have to close the practice whilst they did the work.

The date they gave me in the email was for the following week. I contacted them and said we needed much more notice than this as patients were already booked in. They were quite surprised :roll: :roll: .

So they came and did the work and it didn’t! Work that is! So we had the practice closed for an hour for nothing. They then gave me another date but I absolutely dug my heels in and said that they must do some testing before they did the MALWARE.

Just as well because it failed the test. Anyway to cut a long story short they finally did the work, it worked and we forgot all about it.

Last week they contacted me out of the blue and said they needed to MALWARE a different router. WHAT? On enquiring they said they’d put the wrong one in originally and it would need to be changed. You can well imagine I wasn’t a happy bunny.

You can also well imagine how I felt when (after making some discrete enquiries) it transpired that they had installed a higher spec router than we needed because they didn’t have the right one at the time and now they want it back :shock: .

What chance do you think they have? :lol: :lol: The answer is an absolute and categorical NO! NOPE! NO WAY!

It is not my fault they didn’t MALWARE the correct router and if they think I am closing the practice for a 4th time due to their incompetence well they have another think coming! And if we have a higher spec router than we require they are mistaking me for someone who gives a s***! :lol: :lol:

Re: Life as a GP practice manager

Posted: Tue Jul 30, 2019 9:21 am
by maz
:shock: :shock: The better spec one they mistakenly gave you must be such a lot more expensive, as it costs them a fair bit just to come back to replace it. Yes, you hang on to it. Someone is in trouble there.

Re: Life as a GP practice manager

Posted: Tue Jul 30, 2019 9:39 am
by Janey Dal
Indeed! :lol: :lol: