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Independents' Day

After a week of work-shadowing, health minister Andy Burnham learns what GPs have known for a decade

Minister starts to get the message

By Katherine Haywood

A work-shadowing exercise has convinced a health minister that chronic change fatigue among GPs and other frontline health workers is undermining NHS reform.

Following his experience, health minister Andy Burnham said: 'After 10 years of major change in the NHS, and huge improvements as a result, we need to reflect on how talk of reform is perceived on the front line.'

He spent seven days work-shadowing staff across the NHS, including one day with Dr Sarah Murray, a GP at Peverell Park Surgery in Plymouth, Devon.

Dr Murray was keen to show him how top-down policy directives were putting a strain on her daily work.

'We have so much to do in so little time. The pressure we work under is not easy and sometimes the targets and the bureaucracy get frustrating,' Dr Murray said.

'GPs face constant change. It is very hard to keep adapting to management and structural changes.

'Some of these reforms and targets do drive good practice, but we don't want to lose the essence of doctors' consultations so the patient starts thinking we're more interested in ticking boxes than actually dealing with their problem.'

Mr Burnham sat with Dr Murray during her surgery, chatted with reception staff and patients and met the practice staff at lunchtime.

His perceptions are outlined in the report A Day Out in the NHS, which makes a series of recommendations, including keeping check of rising public expectations, increasing staff involvement in policy development and a reassessment of the emphasis on targets and top-down performance management.

Dr George Rae, Newcastle LMC secretary, was surprised that the minister 'had to spend all that time and all those resources to find out what everyone else in the NHS has been aware of for a decade'.

Dr Nigel Watson, chief executive of Wessex LMCs, said: 'Many GPs like change and challenge but there is so much now that we are unable to respond. It seems, from an LMC point of view, that directives are obsessed with process change rather than outcome.'

Dr Charlie Daniels, chair of Devon LMC, said: 'Sometimes you wonder where these ideas come from. They don't involve the grassroots GP – just the odd-bod in the royal college.'

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