As I fill in yet another survey for the ‘powers that be’ about what we’re spending our time doing in general practice, I again sit there pondering what the survey doesn’t cover.

Normally these surveys specifically single out appointments as a magic gauge to what goes on at the surgery.

Despite several emails over the years asking that the surveys at least acknowledge the rest of the ‘job’, here I am completing another survey about appointments. ‘It’s to help you’, they say.  Yeah, right.

As I run off the search to send with the aforementioned survey and come to the comments section – you know, that bit where they allow you to include some additional information, but you know they’ll never read it – I type away:

“Attached is our survey that shows we had over 1,120 clinical appointments this week which, by the way, is over the usually used ratio of 72 appointments per 1,000 patients. Please could you also take into account the following small pressures on our time. To give you a slightly clearer picture, these are a few things that you might want to consider – all of which happened just this week:

“The normal stuff – 534 lab results, 456 letters, 432 repeat medication requests, 323 emails, 231 tasks, coroner requests, care home reviews, district nurse discussions, palliative care meetings, child protection reports, medication reviews, student reviews, mentorship, registrar reviews, teaching, clinical meetings, partner meetings, training, medical reports.

“Then there’s the stuff that’s not ‘normal’ for the clinicians, like this week: being called to an emergency in the car park where a patient had collapsed, taking a GP and a nurse away from their appointments for an hour; they then worked an extra hour to catch up. A GP covering a colleague’s on-call as well as their own list because the GP has Covid and can’t come in. Spending over two hours helping a suicidal patient get the service they need (ONE appointment!). Visiting a dying patient after work, despite promising their own family they would be home on time. Working all Sunday night trying to clear some of the letters, tasks, blood tests and prescription requests to get a head start before the week begins.

“And there’s the other stuff – that ‘invisible’ stuff that happens: the administrative side, the practice management side. Apart from the huge job of ensuring the health and safety of the whole workforce, managing HR, business planning and sustainability, payroll, taxes, audits, policies and procedures… there’s the other bits of the job too that get no mention in any survey. It’s magic, you see; magic overseen by a practice manager. Supporting the colleague in an abusive relationship, helping a colleague who can’t afford their daughter’s birthday to get through, unblocking toilets, fixing leaks, mending toilet doors that won’t lock, screwing back handles that have fallen off, arranging for security lights to be installed, finding a new cleaning service, supporting the new nurse prescriber, inducting students, helping the new salaried GP to settle in, putting in everything you’ve got to retain your staff, walking around with a smile when inside your stomach hurts from the stress, sourcing extra space, dealing with complaints, being a shoulder to cry on (but not daring to cry yourself), and lastly filling in your ******* stupid survey that has no bearing on what actually goes on in general practice.”

I expect it’ll be filed in ‘BIN’, but it made me feel better!

It seems that Polly is still provoked.

PM Polly