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by Kimberley Hackett
11 November 2015

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Blog: the core of general practice

“I can’t get hold of Hunt seven days a week,” an audience member pointed out at the Management in Practice (MIP) London conference held on 10 November. The blunt remark provoked hearty laughter in Olympia London’s auditorium during the tense opening session focusing on the seven-day NHS.

Jeremy Hunt, secretary of state for health, became quite the focal point for a venting of frustrations during the session, Round the clock primary care: funding, staffing, demand. As financial columnist and MIP speaker, Noel Plumridge said: “I don’t know what to make of [Hunt]. He’s a skilled politician – a survivor. He believes he has a mandate to do this [seven-day NHS]… it is going to happen.”

A view that was echoed by fellow speakers Andrew McHugh, medical practice director, Horsefair Surgery, Oxfordshire and Virginia Patania, practice manager and managing partner, Jubilee Street Practice, Tower Hamlets.

McHugh stated that we have to get used to a seven-day week as it is what Hunt is pushing for and that “we need to be more corporate and work corroboratively,” he said.

Patania, an advocate of seven-day NHS, does believe that general practice should never have to use its own funding for seven-day access.

The big question that caught the audience’s attention was: “Put yourself in a patient’s position. Would you want seven-day NHS?” said chair, Jan Harley-Doyle, general manager, Somerford Grove Practice. The resounding answer from the audience was “yes”.

With the seven-day NHS knocking on practices’ doors and Hunt determined to go ahead with it, it’s inevitable that practices feel they are under an even greater amount of pressure than before.

Michelle Drage, chief executive, Londonwide LMCs (Local Medical Committees), recognised the rising risk of GP burnout and emotional exhaustion that practices face. Rather poignantly she recognised the often-overlooked practice manager. She said: “If GPs feel the burnout so will practice managers.”

Drage’s session, Avoiding burnout: managing and increasing workload within your team and supporting staff, addressed the relationship general practice has with the government. She said: “Broadly speaking, I would suggest practice managers, GPs and general practice are being bullied at the moment and there is a lack of social support.”

She expressed the need to build a resilience culture in the practice and help each other. “The cost of GP burnout is far too great to a practice,” she said.

Care Quality Commission (CQC) inspections can often generate fear within practices, with practice managers, “staying up all hours preparing for inspections” as one audience member put it. But MIP London introduced two practises that claimed the ‘outstanding’ title from the CQC. Aziz Pandor, practice manager, Victoria Medical Centre outlined how his practice succeeded. He said: “The CQC is looking for an organisation that recognises local issues among its patients. But more importantly that you are looking to do something about those issues.”

His words rang true with Michele Golden, head of general practice inspection – London, CQC. In Golden’s session, Creating long-term improvements beyond CQC inspection, she reassured the audience that it is okay to not have ticked all the boxes when an inspection is lurking round the corner. But it is important that these are recognised, documented and that a practice has evidence as to how these will be addressed.

Golden said: “Practice managers are crucial to general practice. When practice managers are involved practices have a better outcome with CQC inspections.”