By Robert Campbell

Tired of Change?

Over the last 50 years I have experienced many NHS reorganisations with new ways of working within GP practices that I think I could be forgiven for saying that I’ve had my fill of change! And I think I’m not alone. I’ve discovered that many people can be bribed – sorry, incentivised – into accepting whatever change is proposed, usually with money but once enough people have signed up then the incentives disappear. That is when ‘change’ becomes ‘no choice’.

In 2004 the Quality Outcomes Framework was introduced; a chance for GP practices to earn points for various issues like asthma and blood pressure management, among other things, but it has changed dramatically since then. Targets alter, indicators are dropped and new ones added and gradually, even though point-scoring is still the main driver for many practices, some QOF indicators have become mandatory rather than an incentive.

What are you – Leopard or Innovator?

Some people willingly and excitedly accept every change going whether or not they have the ability to deal with it. The innovators see change as a challenge and something beneficial to their practice whilst others – the leopards – are reluctant to take on board any new challenge and do so only when they absolutely must. So here’s an interesting statistic; according to the CQC website there are 9,333 practices registered and out of 4,324 inspected, 350 of them did not pass the test. Does this mean that even after more than three years to prepare there are still too many leopards?

Have we changed from the past when GP Fundholding was taken up by only 57% of practices? It’s the same with PMS contracts and now GMS contracts, albeit the figure is now rising. Medical practices are now required to run a Patient Participation Group but according to the Medical Protection Society’s website just over 50% of practices have a PPG. This says to me that there are still quite a few leopards unwilling to embrace change either for incentives or mandatory purposes.

The Rogers Theory of Innovation

Here are some interesting findings from the Rogers Theory’s management of change survey;

• 5% of those involved in change get on with it immediately without question. These are usually the ones motivated primarily by ‘incentives.’
• 5% give it more thought and planning rather than just diving straight in regardless.
• 34% are slightly less enthusiastic but embrace change anyway.
• 34% take more time about it and only embark on the journey with the assistance of as much help, advice, funding and bribery as they can possibly muster. They are usually the ones saying “I’ll do it only because I have to.”
• The last 16% are the leopards. The great unwilling who are always the last to join and will try to get out of it if they possibly can!

So where so you and your practice stand in this discussion? Do your own thing in your own way? Or will you accept changes for cash incentives? Or, do you enthusiastically incorporate every CQC requirement into your practice in the hope of scoring points, even if you believe setting up a PPG is a waste of time?

Be assured there are still many out there who agree with you and, like you, would put patients before points given the chance.