I’m sure that, like me, you care very much about your practice, your surgery, your patients and the service you offer (otherwise you wouldn’t take the time to read Management in Practice!).

Do you therefore share my frustrations with the way we have to meet targets, evidence everything we do etc, whereas community trust’s don’t?

My particular frustration at the moment is over sickness and maternity leave for staff. We are battling in our practices just to ensure our income remains at the same previous level; one way of achieving this is the extra effort we are particularly putting into access: ensuring patients can have access to a healthcare professional within the specified time limits.

However, when it comes to health visiting and district nursing, there just don’t seem to be the same sort of targets!

We have recently had a salaried GP on maternity leave and, of course, we brought a locum in to cover her surgeries. All in all, this cost us an extra £16,000, even after some reimbursement from the PCT. If we have any sick doctors or nurses, we immediately have to add extra appointments to everybody else, and we then need to book a locum if it’s going to be for any length of time, which I’m sure is a similar situation for most of you.

However, when the district nursing or health visiting teams are reduced by maternity or sickness, they move to providing a reduced service! They only take certain cases and don’t deal with many of the routine problems – oh that we could do the same!

The longer the absence goes on, the further reduced the service becomes.  Not only do they do this, but when faced with long-term sickness – and of course with long-term maternity leave – they then appear to be totally hidebound by the payments they are making to their staff, and their budgets do not allow them to put in any cover. They also seem incapable of “managing” staff sickness.

Recent figures from the GP patient survey showed most of our scores were over 90%, the lowest being 83%. All were higher than our PCT average and the England average.

I would very much like to see the same sort of survey applied to PCT community services. I’m sure that in terms of service – in fact I know – they would score highly, as the community staff are working are doing a fantastic job.

However, scoring them on their access times when the staffing levels are so low would really not show such a good picture. That’s my rant for the moment, feel very much better now, having got that off my chest!

What do you think? Is this a bone of contention for you also?