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At the heart of general practice since 1960

A mutiny threatens Dinah's new term enthusiam

DVT problems bring our GP diarist down to earth with a bump

DVT problems bring our GP diarist down to earth with a bump


Thank goodness for the New Term. Exhausted after a busy summer – endless stream of visitors, mounds of laundry, GCSE results (fayourable, thank God) and numerous significant birthdays, interspersed with forays into various parts of Europe. What on earth made me think that driving three kids round the Czech Republic in the rain would be fun? Or that ‘Mum's weekend in the South of France' would be anything other than an organisational nightmare? Even co-opted parents to help with kids, must have been the gin. Never mind. It's Monday, it's 5 to 9 and it's Practice Manager time! Bounce into office bubbling with gossip…

Nobody there.

Slow footsteps climbing stairs… a very tired person appears. Oh dear. SystmOne's crashed for the third time this summer; a national problem, we're unable to function without it. New practice DVT service is challenging to set up. Staff are fed up; mutiny threatens. That's just for starters. She's had enough.


Long chat. Then surgery – whoops! I'd almost forgotten the patients. They're all depressed too. That's nice, I think; that makes everybody. Finish late; try to make some impression on 300+ inbox; fail dismally, give up and leave for Tesco. Better not let gin levels drop too low.


Gradually catch up with patients and news. Interesting range of holiday-related illnesses I've not previously encountered, including ‘camera shop allergy' (asthma attack triggered by buying batteries). A couple of scorpion bites – gratefully sign script for antihistamines (kids' ‘desert survival' manual came in useful after all). And still they queue. Mr F, enthusiastic arthritic grandfather recently off a plane from Orlando, appalled that I've not yet taken the bairns to Disney Florida, tries to donate me his air miles. I protest - he surely needs them with all those grandchildren - when he mentions his red, swollen calf. Aha! Nurse gets positive D-dimer so phone and book Ultrasound for tonight, check we've got enough heparin. At last! A DVT for the new pathway! Much better than sitting in a hospital bed all weekend.

Happily rush off for PBC Group fantasising about all the other practice-based services we could establish and how wonderful that would be for patients. All we need is a slick business planning process. Maybe they've sorted it over the summer. We live in hope.


Never mind inbox (now 350) – possible premises review means a nostalgic afternoon clearing out PCT room. Ten years of files, papers, hopes and dreams; frighteningly little has changed. Smoking, obesity and alcohol still top the priority list. Workforce plans, guidelines, acute service reviews – binned. How I wish Practice Based Commissioning really had the power that was promised. We could do so much.

Interrupted by PM on mobile: Mr F's ultrasound shows no DVT. Yay! A small saved admission for one man; a giant leap for PBC! Practice manager and I congratulate one another: yes, we can do it. It's all worth it after all. And two G&Ts please.

Dr Dinah Roy

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