10.41 A practice manager swamped with paperwork
Rowena Angell, a practice manager in Lostwithiel, Cornwall, describes the frenetic start to the day at her surgery
This morning the sun is shining, the birds are singing and all is well in Cornwall.
The ever-dependable M opens up the building and turns on the computers at 8am, ready to take the telephones over at 8am. Triage time for urgent appointment requests begin at 8am and one second.
At 8.02am M brings me the ambulatory 24-hour BP monitor to download the data from patient X ready to re-programme for patient Y at 8.30am - we run a tight ship here but the secretary doesn’t start until 9am. At 8.05am the duty doctor informs me that one of our GPs has telephoned in sick - a receptionist begins ringing round the patients who had been booked with the GP to offer them alternative slots.
In the meantime, I am looking at e-mails from CQC (fees going up), CQRS (QOF, data extractions, manual entries and timetable over the coming week), Pulse (a reminder of today), Microtest (GPES and HSCIC execution deadline 2.4.14), another practice manager (to let us all know that an anonymous payment remittance is from Cornwall Council, although I’m not sure quite sure why…), the local paper (with an order confirmation for our advertisement for a replacement receptionist), the accountant (a VAT return) and two practice nurses (who want to swap late-night duties).
There’s also the offer of unwanted help with Legionella water testing; I would settle for a free Dynarod survey of our drains. Today they are thankfully not overly pungent, but I have seen one locum who was very unsettled recently in the consulting room most affected.
By 9am there have been 16 requests for urgent appointments and the duty doctor has three patients left to contact. The GP who is off sick had ‘book on the day’ appointments for triage so their absence has reduced our urgent capabilities somewhat; there are four left this afternoon, but we are only one hour into our 12-hour day. Yes, we are open 8am to 8pm on Tuesdays and Thursdays, but only to 6.30pm on the remaining weekdays.
There is no room for manoeuvre this morning as it is minor ops after surgeries, so if more than four people need to be seen urgently today we will have to squeeze them in somehow - perhaps there will be no visit requests? We can but hope.
At 9.30am coffee is kindly brought in by the memory nurse (she never forgets) and the records administrator comes to let me know that the telephone wire she bought for her new room doesn’t work and she will have to take it back. Meanwhile, I have been running searches for the month of March for our enhanced services claims. I decide to spread the good news to loyal staff that they have been awarded a 1% pay rise… it’s not enough but it is happy news.
Thus is the first two hours on 1 April 2014.