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Wednesday 28 September 2016
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Questions over budget continue as the only constant is change

Another month gone – we'll be planning for Christmas soon! In fact, my thoughts are very much with the autumn, when the first of my children will get married! An event I am looking forward to enormously, as long as the patter of tiny feet don't follow too quickly – I'm far too young to be Grandma!

One bit of good news since last month was the decision to employ a PA to help me – hurrah! As the arrangement of managing two practices is to continue, I felt I couldn't continue as I was, so agreement was reached to employ a PA – much to the envy of the clinical partners who all want one as well.

So this month I have been advertising, shortlisting and interviewing, only to eventually appoint from within. Which of course has meant appointing to that vacant post, which caused another vacant post as someone from reception wanted to transfer, which has caused a vacant post in reception. So eventually when all have finished playing "pass the job", I might eventually get my newly appointed PA to do some work for me rather than training her replacement! I can't wait.

The staff problems in reception have not improved – probably made worse by all the extra change. On top of that, we have not decided about cost of living pay increases this year yet. Despite knowing in principle the rise we should get, we have yet to see any confirmation from the PCT.

There is also uncertainty regarding several enhanced services – while we haven't been told these will be withdrawn, equally they have not been renewed yet either. All in all it adds up to a very uncertain budget at the moment, so we are postponing making any decisions on pay. Obviously this does not help us to smell any sweeter to the staff!

I know we are fortunate in the present climate to have a steady income and to be gaining an increase in that income, but it is still a very difficult way to run a business, when so little is known to enable budgetary planning until well into the year.

And then there is the Quality and Outcomes Framework and changes to that, and the question of when we (or the clinical suppliers) will see the rule sets so changes can be made.

Ah well … "Plus ça change, plus c'est la même chose" as they say! Have a good month.