Welcome to the March/April issue of Management in Practice! It's amazing how quickly these issues come around. Having said that, so much has happened since the last issue that it seems like a lifetime ago!
I really enjoy writing this column – it's the one opportunity I have to reflect and offload. It's such a busy period of the year for all of us that there's currently little time for that, what with end-of-year finances and payrolls to facilitate, Quality and Outcomes Framework (QOF) points to achieve, commissioning plans to write – not to mention the day-to-day stuff that just crops up daily.
In fact, there are so many issues to deal with that it's easy to forget what we are really in this job for (at least, sometimes I forget, as I get so engrossed in the politics and policy). For myself, practice management is about providing a good quality, accessible patient service.
Gratitude to primary care
I have to admit, though, to having become a little bit detached from patients recently. Not only is this a consequence of the NHS obsession with churning out paperwork, but the way the structure of our practice has been designed means that I don't actually get much patient contact, and I only get involved when there is a major problem to deal with. Our staff are highly competent and generally only refer to me when they are really stuck.
In fact, they have been troubled by a difficult patient – the same patient – on several occasions over the last few weeks, to the extent that I have been required to intercept. The experience has led me to the sad conclusion that, for some patients, even a high-quality, accessible service isn't always appreciated. Unfortunately, this patient really needs medical help, but refuses to accept it, and I am at a loss to know where to go next.
The point to this discussion, I hear you ask? Well, my point is that this column gives me an opportunity to say thank you – not only to my own staff, who do a damn good job under very trying circumstances at times, but to all of the other frontline staff who perform similar roles. The job may be heartrending at times, and soul-destroying at others, but we all carry on regardless – despite the constant bashing of primary care that Professor Lakhani of the Royal College of General Practitoners (RCGP) refers to in his piece on page 11.
So congratulations everyone, you deserve recognition for a job well done!
New records to be made
IT is a big topic of interest at the moment, which is reflected in this issue. On page 22, Simon Wright considers the pros and cons of the Information Management and Technology (IM&T) directed enhanced service (DES), while our special report considers the implications of the NHS Care Records Service (CRS).
In April, pilot electronic records projects will commence and, as such, a handful of specific primary care trusts (PCTs) will start the process of uploading summarised versions of patients' medical records. Despite the controversy regarding the protection of confidentiality, I remain surprised that in a practice as large as ours (with more than 20,000 patients) we have received such a small amount of requests to "opt out". I await the evaluation of these pilots with interest!
Another featured article looks at the prospect of opening an onsite pharmacy – Ailsa Colquhoun questions whether this is an opportunity that will be around forever, or if it will shortly expire? Should you take the plunge? Read on …