Just trying to keep abreast of everything that might happen seems like a full-time job at present, let alone keeping on top of the day-to-day things that do happen. Still, we'll all rise to the challenge as always – when we know precisely what the challenge is.
Personally I like change and new challenges (within reason), though I think I'm often in the minority. So I'm looking forward to getting my teeth into the future.
It's all change in both of the practices I manage too. A few staff members are leaving, prompting a review of current staffing in each practice. This has resulted in a review of skill mix in the nursing team (we're hoping to create one team that works across both practices), a review of how repeat prescriptions are handled (will we ever get electronic prescribing links? And if we do, will it relieve us of any tasks?) and a review of how we handle IT, again across both practices.
The staffing review is mostly designed to move work from the doctors to nurse practitioners, to move work from nurse practitioners to nurses, to move work from nurses to healthcare assistants and to – no, that's where it stops! All we have to do when this is in place is persuade the GPs to stop doing some of the simple tasks they like and send the patients 'down the tree', so to speak.
At least the IT review looks like relieving me of some work; I will definitely delegate and lose tasks with pleasure! So all in all, we're moving further towards a closer 'federation' – that other buzzword.
The difficulty with this one is that, unlike (or should that be 'like'?) GP consortia, there are umpteen different models; everyone seems to make their own union a little bit different to someone else's.
This makes it difficult to start with, but we are happy with the way we are going at present, which is slowly building on what we can do jointly, where we can share staff and cut costs and generally be more efficient.
Who knows, if we get it right, there might even be some pay rises this year! This may be a bit of a false hope, however, as I can't see that our budgets are going to allow for it. I hope they do, as our practice staff are by and large a very loyal and hardworking lot and they deserve it.
I hope this doesn't sound too down – it definitely won't be unfamiliar. But it's the challenge and the change that keeps me going day after day – at least until the countdown to retirement counts down, but right now that seems to be stretching further and further away.