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What’s it like being a PM in Wales?

by in Practice Life, Wales

What's it like being a PM in Wales?Wales. That tiny bit that juts out to the left of England. We do get out backs up a bit about being left out. Everyone knows Tom Jones and Shakin Stevens but what about our football team or cricketers?! When we receive our various emails about general practice we are bombarded about CQC. In Wales we don’t have CQC. However, fear not, we are not left out from acronym hell.

We too have QOF, we have QP, we also have CGPSA, QP, EH, ES, INR, NPT. We have ISMS, DN, PPV, QA and HIW.

Where would the world be without acronyms. Lol. (see what I did there).

To be fair CQC sounds like a nightmare. Not so much the work but the bureaucracy and the fees! One day I’m sure it will arrive here and seep over from Chester into the green grass of Cymru and all emails will make sense to us all and we can all sigh at the same time at those three frightening capital letters.

In the meantime our equivalent, at the moment fee free, seems to be the CGPSA. The Clinical Governance Practice Self Assessment tool.

I have to admit as a new practice manager a few years ago I found the tool really useful. I had no idea what I was doing and I thought QOF was some kind of lung disease. So to have a bench mark, to have an idea of what we had in place and what we could have in place seemed like a good place to start.


There are issues.

Firstly we get the tool, as usual, about eight months into the year. This is the most frustrating side that I have found working in general practice. We have targets that have been set from April, yet we only get the software in October. All the experienced practice managers tell me ‘that’s how it always is’ yet I still feel the same. How can that be? How can it be set that practices are expected to reach targets for QOF or complete their CGPSA effectively when the software isn’t provided until at least six months after we should’ve started it!

Rant over.

The CGPSA deadline is looming. How many matrices this year – 50 plus? The form has improved so that is a start. The self scoring is rather strange. You can score yourself 0 or you can score yourself 5. What I find a bit difficult is you can have some bits of 5 and you may not have 3 or 4 so are you still 5?! There’s a box then about how you can prove these levels and also another about how you’re going to work towards these levels. There’s a date and a box who is delegated this responsibility.

The PM of course!

Part of the angst and disengagement with the CGPSA is the lack of feedback over the years. I’ve yet to see a report or any verbal feedback at all about what is done with this data. There are even rumours on the practice manager grapevine that the typed part of the document hasn’t ever been read. It could all be nonsense. I think the fact that we’re discussing it and don’t know says a lot. What happens to these matrices? Are we creating a picture and helping improvement or is this another tick box exercise ensuring someone will take the blame should it all go wrong. Tick the box that says you provide pink toilet roll when you actually only provide blue at your peril! That’s if anyone actually is bothering to read about the colour of your toilet paper.

Practice managers have a reputation for being rather negative and pessimistic. When I first came into post, only 4 years ago, I attended Practice Manager regional meetings with enthusiasm. It was only when the ‘older’ ones laughed at me when I asked simple things like when would we get our printers replaced or, this one got even more of a laugh, where could I get some funding for staff training?


Let’s not leave you thinking Wales is all doom and gloom. I love my job, I’m not 5 years in yet but there’s a lot to be thankful for and I believe in the service we provide. I’d just like to get on with it without having to document how many biscuits are in the tin and how many times I’ve washed my hands this week.

It’s not CQC but it does leave me with some choice acronyms that I like to use myself. I’ll leave that one to your imagination.


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Dwysan Rowena

Dwysan Rowena

Welsh Practice Manager

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One Response to “What’s it like being a PM in Wales?”
  1. Avatar
    Mels Says:

    so true.
    Have been doing the self-assessment tool kit since the year dot. the forms have improved, that’s one good thing. but as you say never any feedback..
    if only there was a report that even told us how we did compared to others.. is everyone in our Cluster at the same level?
    and yes scoring the level. I found I’m either a 1 or a 5 in most things, but then if I’m not doing what’s in level 2,3 & 4 then surely that means I’m a 1??? very confusing. no feedback. access to it is limited to very few months in the year.
    Good article. Spot on!


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