As the GP workload increases to critical levels, it’s helpful to know of small ways to improve the way your working life is organised. Here are ten tips for reducing the amount of time you spend managing paperwork, emails and meetings.
1 Get a smart solution for document sharing
As GPs we are becoming increasingly busy and reliant on mobile devices. When you’re mobile and important documents keep changing all the time – it’s crucial that you have the latest version. In my CCG, we decided that we needed to standardise access of all documents and ensure that everyone is working on the same version.
I’m not based at my surgery all week, only working there for two days and the days are gone now when we used to keep folders archived at the surgery. Many colleagues are now in dual roles (clinical and managerial) – and also we need to work from home, out of ‘normal’ hours, more than we did as workloads are generally higher.
I was keen to find a new cloud based document management system and quickly discovered Microsoft Office 365. Security and data protection is paramount, and as none of the documents we need to share have any patient sensitive information on them, this particular cloud solution met our requirements well.
Other tools you could use include Microsoft SharePoint – a tried and tested solution that’s often used in the NHS. The downside to SharePoint is that it can be tricky to access from home and sometimes isn’t very user friendly if you have multiple roles.
2 Make it clear who’s changed a document, when, and what’s new
This is a learning curve for us but we’re getting better at naming documents more systematically. We started off with one style – name and date – but as the documents are automatically version-controlled, you don’t need to add a date which keeps it simpler.
3 Reduce email traffic with instant messaging
We identified the need for a chat function to reduce email flow as part of the new document solution. So we now we use Microsoft Lync. With Lync you can who’s online, and ask quick questions without emailing. You can also share desktops through it so you can edit a document together. You can access Microsoft Lync on mobile devices like, Apple and HTC, and from any location including home computers, not just via NHS secured devices. Alternatively, use Google Chat or MSN Messenger if you don’t want to use Lync.
4 Making use of messaging during surgery
In our practice we use the EMIS system, which has its own system messenger. So if you have query about prescribing or referring, for example, during a consultation, you can send it around to one or more colleagues to get their help. If you don’t want to leave a patient alone in the room but you need, say, blue slips for a prescription, you can message a colleague. It’s more subtle than a phone call. EMIS chats are ‘safe’ for sensitive information.
5 Meet face-to-face – when it matters
Avoid meeting overload – and don’t travel for longer than the meeting actually runs for. Audio conferencing works well if you don’t need to meet up in person – there are lots of professional programmes for this such as Arkadin or TurboMeeting. Skype is ideal for informal conversations – for instance I have a regular meeting with a colleague over Skype or Facetime, which is fine when you’re not disclosing any sensitive patient information.
However, you need to meet in person to discuss critical issues and sensitive information. The problem with relying on audio or video calls is that they have to be a good quality for everyone to have the same involvement in the conversation. If someone’s dialled on a poor line, they’re driving, or there’s any background noise you can’t hear them well, and ultimately reduces the quality of the meeting.
I used to have a meeting in London every other month, but now I hold a teleconference instead – it saves money on the venue, travel - and your time.
When we hold our weekly clinical meeting in our practice on Monday mornings, we have 16 partners in attendance, plus extra staff. We are in the process of introducing conference call facilities, so everyone can participate in the meeting, even though they may not work that day.
6 Vote on practice business decisions anonymously
We hold partner meetings in person, but sometimes we switch to email to vote on business decisions anonymously. With 16 partners’ opinions to consider, it’s important to recognise that people don’t feel obliged to vote one way, or offended by a colleague’s decision. There are plenty of free and easy to use tools to manage this – voting buttons in Microsoft Outlook is an obvious example. You could also use the free online tool Doodle.
7 Check emails twice a day, and flag important ones
Smartphones can be a bit of a curse for GPs, as you can configure NHSmail to appear on most devices now quite easily. But what you think will be a ten-minute check can soon turn into a time-consuming habit.
I went on a course last year, and the best tip was to look at emails twice a day. I didn’t practice it until over Christmas, my iPhone experienced technical problems, so I’d check once a day and couldn’t check more. I got better at responding and prioritising and I’ve learned to cope without 24/7 access.
Twice a day might not be right for you but be good and limit yourself; could you survive on a morning-and-night check? Now on a Monday and Friday when doing clinical sessions, I have an out of office which lets people know that I won’t be able to respond to them immediately – this might be another way to stem the tide. There’s some emails I ‘VIP’ on my iPhone to bring them to the front screen when they appear, even when it’s locked, which reduced ‘speculative’ checks on my email. VIP mail allows you to create settings that automatically routes mail from the people you designate as ‘Very Important People’ into a special folder in your device’s Mail app – it comes as standard on an iPhone 5, and other iPhones/iPads that use the latest Apple operating system (iOS6). There are other VIP type apps available for Smartphones and android devices – just check out your app store.
8 Learn to be a good chairperson
The only way to be an effective chairperson in face-to-face meetings is through experience, but it’s a key skill. I would say the four most important things are: ensuring your objectives for the meeting are being met; knowing when to be quiet; time keeping and noticing who hasn’t contributed. We try to keep to time and use a realistic agenda for the slot we’ve got. Respect the people joining you and plan carefully. Be willing to take things forward and keep accurate minutes, especially on things that you need to follow up. Lastly, notice if people don’t contribute and encourage them to participate.
9 Proof-read minutes from meetings
Choose the right person, with right skills to take notes - their skill set should reflect importance of meeting.
If you chair a meeting you must proof-read the notes, especially if you’ve discussed sensitive information. It doesn’t take long, but if it’s not quite right I always double-check things with the relevant person. Names must be checked, and be careful that things said in jest are not taken down as serious remarks. Think about your audience too – anything that is going to be published definitely needs to be approved and proof-read.
10 Get outside help to improve your communications
At practice level we make sure all partners have sight of documents before they’re signed off. We also have a legal lead who works closely with the solicitors, and a financial lead linked to the accountants, so we call on their particular experience. Think about your audience; we regularly ask our PPG to review our external communications to ensure they are clear and easily understood. We also ask them to regularly check the information on our practice website.
Get communications advice and support, if it’s available. We’ve greatly benefitted in the past from have both strategic and operational communications advice.
Lastly, as someone working in a CCG, it’s really important to work with the LMC on our communications, where appropriate. It ultimately means were joining up and facilitating wider engagement. The LMC also has good lists of stakeholders which improves engagement with particular groups that we may miss.
Dr Masood Nazir is the information and quality assurance lead at Birmingham CrossCity CCG and a GP in the city.
Pulse Live: 30 April - 1 May, Birmingham
Richard Apps, partner at RSM Tenon accountants, will be presenting a session on ‘Maximising your income and keeping an eye on your cashflow’ at Pulse Live, Pulse’s new two-day annual conference for GPs, practice managers and primary care managers.
Pulse Live offers practical advice on key clinical and practice business topics, as well as an opportunity to debate the future of the profession, and a top range of speakers includes NICE chair designate Professor David Haslam, GPC deputy chair Dr Richard Vautrey and the Rt Hon Stephen Dorrell MP, chair of the House of Commons health committee.
To find out more and book your place, please click here.