Now that autumn is definitely here I hope you all had a good summer! "What and when was summer," I hear you all ask. Now it wasn't that bad, I can remember some lovely days. The most recent being in September when my son was married; a really beautiful warm day, when everything was perfect …

Enough dreaming! Back to reality and all those piles, which now seem to be spreading from the desk. Am I getting really grumpy or is everyone else experiencing a huge rise in their workload too?

I have been around for a few years (in practice management I mean!) and there has always been masses to do and plenty of change. I actually like change – I thrive on the challenge of something new – but the quantity lately is beginning to tell.

For me, personally, the mass of new DESs and LESs, planning for swine-flu vaccinations and swine-flu cases, along with the many other changes that seem to be in the pipeline, are pushing other "day-to-day" tasks to one side.

The time to talk to staff, listen to them, support them and work with them is forever squeezed by the paperwork. I have always made time to walk around the surgery at least twice a day; I am now planning larger chunks of time to devote to staff – and patients. Some of the paperwork will just have to wait!

Ah, but there's the dilemma – choosing what can wait and what can be delegated. By the time that has been done – oh, and there's just something else that has to be done today, and that by tomorrow – suddenly it's the end of the day again and that person you were going to spend time with has already left!

I try very hard to plan, but the only time I seem to achieve what I set out to in a day is when I work at the weekend.

I'm sure it's the same for most of you – or is it? Perhaps someone out there has got it cracked, has a great system in place, and feels on top of everything? If it's you, please share your secret with the rest of us – we'd love to know the answer!

Well, I've done a lot of moaning, but I feel somewhat better to get it off my chest, though writing this has not helped clear the work … I'll really try to be more positive next month!