The latest thoughts from our undercover practice manager...

Wow, my last blog certainly stored up a few opinions! Many varied, as would be expected, some for regulation and some against. I too can see both sides of the argument and certainly don't want to see extra bureaucracy imposed on us.

However, to be taken seriously we should all be subject to a robust annual review and appraisal process, ensuring we attend to our continuous professional development (including keeping proper records!).

It isn't necessary for this to be part of QOF or some such (although gaining points might be the way to get GPs to treat it seriously) or part of a heavy regulation process. It's about having clear standards for practice managers, so that practices/GPs, as businesses, have something to benchmark their manager against.

Ok, I'll get down off my soap box on this one now, but hopefully I've managed to get many of you at least thinking about this.

A strange year so far isn't it? I can't believe we've been busy 'jabbing' everyone at flu clinics again already. Then someone cheerfully told me there were only 59 shopping days to go until Christmas this morning and was asking who has made their cake and pudding!

Whenever I try to think about, and prioritise, the many tasks on my 'to do list' (not least being make Christmas cake and puddings) everything seems to lead back to commissioning (perhaps I could commission someone else to make my cake and puddings…).

Part of me is quite excited about the prospect of actually playing a part in tackling some of the commissioning problems and really making a difference. Part of me feels we've been here before, even if in slightly different guise – I've been around so long now, I've lost count of the reorganisations.

And part of me wonders if we'll ever get to grips with the huge amount of data pouring into the practice for verification and comment.

I certainly feel that we are going to have to adapt our working practices substantially to get to grips with this, while still running the practice and ensuring we get the maximum return from businesses with falling income and rising expenditure.

All this, of course, needs competent management. This brings me right back to where I started. When did you last have a review that looked at your competencies and appraised your needs? Or have you even appraised yourself to see if you are 'fit for purpose'?