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Blogging GP Dr Peter Weaving reveals what gets discussed in the clinical leaders meetings

Every week I sit down with my senior consultant colleagues in the local acute trust. Officially it's a clinical leaders meeting – or demand management meeting depending who's written the minutes. Practically it has turned into a very useful operational trouble-shooting forum with senior docs and their respective managers. We cover everything from bowel prep. to unblocking beds to handling stroppy local politicians and building new hospitals. We beat each other up about our respective areas of poor performance with varying degrees of good humour – 'you're doing too many operations' - ' then stop referring so many patients'. We congratulate ourselves on having nice patients who go to their GP instead of A&E and if they do come to hospital they don't steal the hand gel to drink (it's 40% proof). Overall we rub along knowing we're in the same straitened environment with roughly the same aim for the punters we look after – effective, efficient and affordable healthcare.

Why do we meet? In a nutshell we learned at the beginning that if you want to modernise clinical services you need clinical engagement. GPs and consultants have an extraordinary ability to block and stifle change and innovation; if they are unconvinced of the effectiveness of a development it just won't happen. To their natural conservatism add the very real division the current market arrangement of PBC puts in, and you see the widening gulf between primary and secondary care. Small wonder we have to meet every week to bridge.

Dr Weaving is a GP in north Cumbria and locality lead for Cumbria PCT

Dr Peter Weaving