(Time to read: 4 minutes)
By Nicola Davies
I’m writing this blog at 11.30 at night. It’s not anything to do with the fact that I’m an OCD-riddled control freak with insomnia (though that is true) AND definitely nothing to do with the menopause, which must surely be kicking in by now. No, it’s just that I have absolutely no time during the day just lately and I can’t work out why. Well, that’s probably not strictly true, I’ve got a good idea and I’m sure many of you are having the same struggles.
We’re in the envious position of being a practice that ordinarily, outside of high tourist activity, can offer you an appointment with a doctor today. Not an urgent one, but a routine one at that and I know from past experiences that this is very, very unusual. At this time of year, we’d normally have a bit of breathing space, a chance to catch up on admin tasks that have gone by the wayside – chase up a bit of QOF, do a bit of housekeeping, that sort of thing.
But in the last couple of months, no sooner have I arrived at work at 8 am… but lunch has been and gone, (and always a soggy sandwich at my desk) and all I seem to have done is answer emails and generally ‘firefight’ problems that seem to find their way to my office. “I know you’re busy but….”, “the door was closed, but I’d thought you’d just like to know…”, “can you just speak to Mr So and So who wants to complain about the toilet…”, and so it goes on. The endless interruptions, the phone calls, and bang goes that task you were determined to do (you know, that urgent one you told the dog about this morning…) and before you know it, it’s 6 o’clock and actually you’ve done literally none of your work. It’s not that I think I’m poor at time management – I’ve been doing this gig for long enough now to get my head around that nugget! It’s just that time literally is flying and there seems no respite from it.
Everything feels extraordinarily busy… our dispensary is working at full pelt but they’re at least 24 hours behind where they should be. One issue is that patients are coming back for meds earlier than our usual 48-hour turnaround – so perhaps we’re being unrealistic and now we have to consider pushing that back to three full days instead of two? Cue a lengthy discussion with the patient group. I had a conversation with a colleague the other day about a patient who wanted to know why they hadn’t received an appointment from the hospital. It turns out their referral was sent five days earlier – but their expectation was that an appointment would be sent within two days of seeing the GP. No-one had said this would be the case, they just simply felt that this is what would happen.
Since we changed computer systems, we’ve been on a vertical learning curve. Despite my advance planning, my contingency plans, getting in additional staff because I knew we’d be slower, the number of tasks (contacting patients, dealing with pathology/hospital correspondence etc) has risen massively. I know we’re slower, so I’m helping out the reception team deal with these, but of course that impacts on my job. Most of us will regularly bring work home or stay late – because of my insomnia, I can actually get shed loads done at home when my husband is asleep (and he can sleep on a washing line!). However, this approach won’t work for everyone. So, how do we catch up? How can I be pro-active, when all I’m constantly doing is being reactive to whatever c**p hits my desk?
I’d like to get off the treadmill for just an hour or two, take a breather and take stock of where we are – what do I want to achieve and how am I going to achieve it? But that’s pie in the sky at the moment, especially if you add in staff sickness and holidays; you’re feeling the pinch across the whole team.
So, I work from home after hours on a regular basis, I’ve got into the habit of typing up a ‘to-do’ list each night and I email it to myself for the next day – it’s a good way of ‘bullet pointing’ the urgent things and at least if I can do three or four tasks, I’ve achieved something. Accepting that I will never achieve everything I want to do today is half the battle; accepting that I’ll have to bring work home to catch up is the other half. I now just need to get other people on board with the whole accepting we’re not Speedy Gonzalez. Anyone under 30 reading this can ask their parents who that is!
Now, I’ve just got to tell this hot flush to ‘do one’… I haven’t got time for the night sweats!
By Nicola Davies
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June 22, 2018 at 8:20 am
Just not enough hours in a day! I think you need a very trustworthy, capable, assistant manager or office manager to deal with all the distractions and day to day moans and issues with the toilets, computers etc. Maybe you already have someone who could be promoted to this role. This would allow you to get on with the more strategic elements of your management role. Think you need to put a case to your Partners and cross your fingers!
June 22, 2018 at 9:38 am
Hi Julie – thanks for your comments. I do have an assistant who is more than capable of doing tasks as you mention….the blog was really to highlight how extraordinarily busy we all are in the current climate. My deputy is very busy too with jobs that only she does. We are a three site, rural, dispensing practice and that in itself throws out different challenges that I didn’t used to face in a one site, non dispensing practice where I worked previously (without a deputy!)
Thanks again for reading – I hope the blog brings a (rue) smile!
June 22, 2018 at 10:42 am
HI Nicola
I read your blog and can relate to all of it especially the ‘I know you are busy but…….’ which really annoys me after I have advised the staff that I will be unavailable for a while, so I hide away in another room, just like my GP does; to escape! My GP has to hide away in another room and lock the door, its that bad lol
It did make me smile though and feel your pain at the same time!
June 22, 2018 at 10:37 am
I work in a deprived area with mixed nationalities and high numbers of non English speaking patients. This pattern of working is our norm and despite dramatically increasing the number of appointments over the last two years, we appear as far away as ever from meeting demand. The inequalities appear to be widening with “blanket” funding policies. Patients are more dependant, demanding and have increasing expectations. Our job roles are ever expanding. We need to have the skills and knowledge equal to several university degrees , on topics such as safeguarding, information governance, legislation etc.. We also need to be able to operate several software programmes such as the health records system, payroll, risk tools, accounts, workforce tools, and more. We need to be able to write searches, concepts, and templates that integrate with the systems. We need to be trainers , counsellors, ambassadors, HR specialists, amongst a whole myriad of other things. its no wonder we don’t have any time .
We all should have a gold medal for outstanding contributions to our practices and people.
That done, I can’t help but feel exploited , not by the Practice but by the system. We would cry outrage at discovering people in other countries working to excess but we really don’t have much of a choice if we are to get the job done . Our Practice just can’t afford anymore staff and there is a fine line between what the GP partners earn and their potential earnings as locums or even salaried GPs . It suits the NHS to call us businesses but we are not. Businesses gain from more customers , overall we lose money as our typical type of patient generally cost more than the funding provided. Businesses gain from providing more services but we are being asked to provide many services at a loss and are rapidly losing any profitable ones to private companies who will keep the profit and expect to increasing profits year on year. They will not plough it back into services that were not funded properly to start with like the practices end up doing.
Great Blog Nicola, as it made me feel I am not alone