Management in Practice blogger Tim Qwough casts his critical eye over the events of the past year, recalling the impact they had on surgery life
Sometimes the road ahead appears long, but looking in the rearview mirror doesn’t show the whole journey already taken.
Apologies in advance for frightening you all, but it’s a quarter of a century since we were worrying about aeroplanes falling out of the sky and banks losing all their money because of the ‘Millennium Bug’.
Looking at an equal time before that – that is, a quarter of a century earlier than the Millennium – it was 1975, The Wombles were at number two in the pop charts, everyone was on strike and the banks were losing all of their money anyway.
Back to the present day and the momentous year we had in 2024. We saw a change in Government and a change in policy, a focus on health and social care in the offing and a ‘new dawn’ where we will have the funding in all primary care and community services that we have had taken away.
Our patients will finally see the rewards of our efforts through austere times.
Mmm, of course they will …
So, how did 2024 pan out?
January came with a warning that doctors should avoid any gifts from patients which is absolute but reminds me of a practice near a small fishing village where I worked around 2002, and a very happy patient walking into my consulting room telling me he had crabs. There were two lobsters as well.
In February, and after months of form filling, we were allocated some funding to update our old telephone systems for something on the ‘McCloud’, which I assumed would affect my pension. (Alas, it turned out this was nothing to do with my pension).
March and April brought about the real chance that GPs could agree collective action in order to highlight the reductions in general practice funding and the issues this would create for our wider teams and lower paid members.
While the minimum wage again catapulted many percentiles (and rightly so), NHS England told us we’d get no more than a 2% rise – a familiar case of not knowing your ARRS from your elbow.
As we moved into Spring, we had the fantastic news that King Charles would become the new royal patron of the RCGP. I remember the celebrations at our little practice – we bought some bunting from the internet and some swan flavoured pasties from our local Greggs.
June was a time to ‘bust out all over’, when a campaign by practice managers ensured PCNs received full payments for IIF targets on appointments that had been impossible to achieve. This was a very well put together argument led by the Institute of General Practice Management (IGPM) and shows just what a collective voice can achieve!
In July, it was hammering down with rain again and, of course, we all need to look at what we can do to alleviate the climate crisis. Surgeries were given a toolkit that asked us to consider whether we could deal with some queries over the telephone rather than ask patients to come to the practice for a face-to-face appointment.
I recall dealing with a complaint from one patient who told me I was advocating non-proven socio-political issues with no regard to his actual medical needs. As a compromise, I sent him his fit note on recycled paper and then hand-delivered it by driving to his house in my 4-litre diesel Range Rover.
In August, we all received the welcome news that the salaries for ARRS roles had been uplifted. Phew. Although, of course, we were then told that the overall financial envelope was to remain the same and so I had to make one of our social prescribers redundant. I then received backlash because of his previous efforts at reducing the carbon footprint of patient travel to our group of practices. Honestly, the heat he gave me afterwards.
We were told in Autumn that practices had to share our telephone data with NHS England or we’d face serious consequences. Ironically, I called them to complain about this and, after choosing four different options and ending up in a queue for two hours, I gave up.
The latter quarter of 2024 has seen a promise of investment, then a reminder that we don’t count (just two letters – NI – spelled that out clearly). It’s the usual panto!
Lastly, we have news that some GP surgeries will have access to an advisor on site who is a trained job coach and will help people find a way into better employment. I’m not sure that has been thought through – I’m really hoping that the first clients aren’t members of the practice team!
Happy new year!
Tim Qwough is a practice manager located north of Watford
