Phil knows exactly what he thinks about the pen- pushers who keep sending him evaluation forms
If there's one thing that has become emblematic of the bureaucratic nightmare of the modern NHS, it's the evaluation form. The feedback form, as it is also known, defines exactly the grandiloquence and meaningless tosspottery of the NHS manager and the careerist meeting-monkey.
No meeting, no lecture, no encounter or interview can be allowed to happen without the subsequent A4 sheet inviting feedback. ‘How would you rate this meeting?' it asks. ‘How can we improve what we deliver? What other subjects would you like to see covered? Was it poor, below average, average, above average or excellent? What went well? Please add any further comments in the box below.'
It's been a long and rocky road, but I'm pleased to say that I am finally done with the evaluation form forever.
It started with our local cardiology department, which suddenly abandoned the traditional typed narrative outpatient and hospital discharge letters in favour of a meandering, mostly irrelevant six-page tick-box standardised printout. At first, it had an evaluation form attached to the front. ‘Tell us what you think of this new format', it invited. So I did.
‘Terrible!' I wrote, on five or six of them. ‘What the hell is going on here? I can't understand any of it! What has happened to my patient? I can't extract any information from this morass of bloody nonsense, get yourself sorted and write it down in plain English!' Of course I heard nothing in reply, and after a month or two the evaluation forms disappeared and two years later we are still filing six pages of rubbish into the patients' notes without any real grasp of what has happened to them.
More recently I had my GP trainer's evaluation here at the practice. Two chaps came along to interview me about my training ‘issues', and I took the opportunity, during what will be (I suspect) the final months of my training career, to take issue with the paperwork. ‘I'm not happy about this', I informed them.
‘Previously, I would just do stuff with the registrar. Now I'm supposed to fill in all these forms to prove I've done stuff, and evaluate it and reflect on it. I've been a GP for 17 years, I write in a magazine, I reflect all the time. I'm a professional and you're insulting me.' To give them their due, they conceded that I had a point. Then they gave me an evaluation form so I could reflect upon the experience.
Well I'm sorry lads, if you're reading this. You're not getting it back because I made it into a paper aeroplane. But admit it – you weren't going to do anything with it anyway.
This afternoon I was at a meeting where two paper-jockeys from the PCT spent an hour explaining our new mental health service ‘model of care' without even once using the words ‘psychiatrist' or ‘consultant' (although there was way more than enough use of ‘pathways', ‘service-users' ‘process', ‘outcomes', ‘equality and diversity', ‘inclusion', ‘stakeholders' and ‘health and well-being') and when I taxed them about this afterwards I got two sheepish smiles for an answer. And an evaluation form.
It's two years since I filled one in. I refuse to participate in this flimsy pretence of two-way communication. They are merely a paper shield, provided so that those who dictate to us can pretend that they've had feedback and considered it. Next time you lick your pencil and debate internally whether to ring box 3 or 4, reflect on the value of your time, and whether you're spending it well.
Dr Phil Peverley is a GP in Sunderland
Dr Phil Peverley Dr Phil Peverley
