Drowning while they throw bricks – what hope is there for the NHS?

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We are sinking The NHS is haemorrhaging talent – to retirement, emigration, the private sector and leaving medicine entirely. General Practice is perhaps worst hit with 40% of GPs planning to leave in the next 5 years and the shortage of GPs making it insanely difficult to access GP care. And a 2.1% annual uplift in funding when inflation is at 11% means that practices will be able to afford even fewer staff next year. No one is coming to our rescue The government’s response has been to demand that patients have assessment at first contact despite the lack of … Read more

How to break the NHS

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The NHS has many strengths and has been a remarkably resilient organisation since it was founded in 1948. But if we want it to continue, we need to be aware of its weaknesses and what to guard against. So, what would someone who deliberately wanted to wreck the NHS do? Encourage patients to overuse NHS services The NHS is a community service which is dedicated to the health of the population. It has economies of scale because we all pay for it and are covered by it. This makes it difficult to break because private services cannot compete on cost … Read more

Charging for GP appointments is dumb

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There’s a lot of talk about fixing the GP workload crisis by charging patients and using price to influence supply and demand. It seems to work for Dentists and reducing plastic carrier bag use but is it actually that simple or is reality a bit more complicated? Making a dramatic change like this could have huge unintended consequences and we need to be clear about what we are doing. Collecting money does not do any patient care. The overheads of setting up a collection system, issuing receipts, chasing payments and administering exemptions is all wasted. It is like forcing everyone … Read more

There aren’t enough GPs because they’ve made the job rubbish

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This is the elephant in the room for GP recruitment and retention. Over the last 10 years the job of being a GP has been systematically trashed by successive governments and by the press. The warnings that doctors would leave General Practice have been ignored and now the chickens are coming home to roost with access to actually seeing a GP being near impossible in some areas. The question is: What do we do about it? What actually works What we don’t need are unevidenced retention “initiatives” The idea that golden hellos and golden handcuffs or more training or more … Read more

Practice Strategy – stop doing stupid things and find your Superpower

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Working out a Practice Strategy can seem daunting but it is an essential task. It starts with not doing stupid things that make a fast buck but eventually wreck your business (that’s what they call short-termism). But the fun part is discovering your superpower and then leveraging the living daylights out of it. That’s when the magic happens. Stop doing stupid things The problem with Short-termism is that it seems perfectly logical. You need to balance the budget so you think you need to sack good staff to make sure the numbers add up.  You think it doesn’t matter if you have … Read more

Purpose – why it matters and how to discover it

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One of the characteristics of modern life is that we get so caught up in endless activity, that we never really think about where we are going, and what it is all for. Sometimes that’s because we feel we are too busy just keeping afloat, but even when things are going well, it seems self indulgent and superfluous to spend time really thinking through what is important to us. But having a well articulated purpose is critical to leading your team and making effective decisions. Purpose is where the fun is We often think of that purpose is a sort … Read more

Listening – The secret weapon to keep your staff

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Losing an experienced team member is a catastrophe. But how do you keep them when you can’t just throw money at the problem? Building a culture where your team feels they belong and that they have a say in their work is critical. And the most effective way you can do this is to make them know you are listening to them. Listening isn’t passive We tend to think of listening as simply hearing the words people say, but it is more than that. Listening is taking in the words, understanding what was behind them, and showing the speaker you … Read more

How Viral Recruitment saved our practice

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It was the summer of 2019 and we were in trouble. Since the retirement of our senior partner in 2017 we had been trying to find her replacement. And we had failed. We were a nice practice, with a nice income, and nice patients in a nice neighbourhood – and nobody wanted to join us. Something needed to change. And fast. Otherwise we might fold. How did we get there? We had been a very stable practice with the same 3 GPs working together since 1999. When retirement loomed, we did our homework and looked at how people advertised. We … Read more

How trusting patients actually controlled our workload despite the Pandemic

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The Pandemic has been a rough time for all practices, and the biggest problem we have had has been the crushing workload. Some have turned to Doctor First, Total Triage or AskMyGP but many surgeries still report out-of-control demand and difficulties coping. We had strong long-term relationships with our patients, and they tended not to bother us unless they had to. So we decided to use that trusting relationship to help us provide more and better care, and the result has been that our workload has been controlled even during the Pandemic. So what is our workload? A doctor does … Read more

Sorting out GP workload 3 – Patients on the team

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There is a lot of talk about promoting self care. But much of this seems to be telling patients off for seeking help with genuine problems. Or else giving them lots of bewildering choices and telling them it is up to them to decide. If we treat patients as overly demanding customers then that is how they will behave. But they are our registered patients, we know them, and they know us. Would it be crazy to enlist the help of our patients as members of our team rather than just consumers? We all want the same thing We exist … Read more