Bullshit bureaucracy is back to block the system
Copperfield harangues the red tape and bureaucracy getting in the way of him doing his job
Maybe I just dreamed it. But you know that viral phase we all went through a few years back? Wasn’t that supposed to herald a new and ongoing era of all overbearing and soul-destroying GP regulation/bureaucracy etc. being trashed?
If so, how come I currently feel so straightjacketed by mandatory scrutiny that I might as well be suffering Covid-induced hypoxia? That red tape wasn’t trashed, it was recycled.
Hence, for starters, my appraisal. No longer a brief, cosy fireside chat, but more my feet turned towards the coals for a couple of hours. I’m blaming the process – not the appraiser. Even he apologised for a bizarre final section in which I was asked to agree with a statement apparently prescribed by the GMC which went something like, ‘I promise to do my best for patients and not to hurt them’. Well, I certainly didn’t want to before, but I’m in two minds about it now.
It was all very CQC-like. Speaking of which, word on the street is that they have upped their game – aka dusted off their clipboards and lethally sharpened their pencils. Hence some random audits including checking the eGFR of CKD patients on DOACs every 10 minutes (I exaggerate) and ensuring every DNACPR form is reviewed annually (I don’t – exaggerate, nor do this). Yes, that’s those DNACPR forms where we tick a box stating, ‘indefinite’. Anyone see any logical or ethical incongruity in being compelled to review, every year, a decision we’ve professionally deemed never to require review?
No? OK, my last, and trump, card: mandatory training. Gotcha! I genuinely thought this had just been an embarrassing phase we went through, like acne or writing poetry age 13. But no, it’s back. Today, because they’re ‘due’, I have done my health and safety awareness training, duty of candour training, whistleblowing training and manual handling training – the latter useful for being a heartsink bouncer. But otherwise I’ve had better days.
Yes, I know the CQC doesn’t actually mandate any training itself, it’s up to the organisation etc etc. But when the genitals of the profession are hooked up to the PAT-tested electrodes of the regulator, it fosters a culture of terrified defensiveness which results in us being mandatorily trained to the edge of insanity.
And that was my admin morning. Madmin you could say.
Look. Ask anyone who really knows, and you’ll discover that this culture of patronising, mindless hoop-jumping bullshit has a net-harmful effect on doctor and patient by gobbling up goodwill and appointments.
So I intend to use my new skills to speak candidly about, and blow the whistle on, red tape; manually handling it healthily and safely to the right receptacle. Which, because this bureaucracy is a criminal waste of clinical time, is the clinical waste bin. And that’s not for recycling, it’s for incinerating.
Dr Tony Copperfield is a GP in Essex
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READERS' COMMENTS [12]
Please note, only GPs are permitted to add comments to articles
Brilliant as always TC
Appraisal should be every three years. Sneaky NHS minions try to add mandatory training, which is not a GMC issue or requirement: BLS, even though I have ALS. The GMC forbids adding local rules to the GMC appraisal process, but NHS England loves to. They threatened and reported me for the GMC Responsible Officer for failures of recent BLS training, ignoring ALS. God bless the RO as he said he could or would NOT do anything about this information and I was revalidated. NHS England and BLS local requirements is an empty threat, but on reading it seems very threatening. Only GPs must register twice, once with NHS and again with GMC. The performers list must be scrapped and register as specialist as we are in Australia. The NHS should not be involved
If you go onto LinkedIn there are disturbing hints that the CQC are overstepping their remit.
Move to Wales :- we still have pounds (sterling and avoirdupois, with garden peas too), miles, and inches on our rulers. We can still receive most English TV channels, although reception is not perfect for those of us on the west coast. But we can get Irish radio instead, so it is fine.
Appraisals are on MARS, and no so prescriptive. But we are not under the NHS, so NHSE cannot bully you – we have something called NHSW instead! (and our own MPL)
“Oooarf”, groaned Don Jaffa, “me system’s all clogged up with bullshit tacocracy. Elon, do summat.”
“Chainsaw” whips out his SpaceLink DynoRod and bends like a surgeon over the Orange one’s rear where something turd-ish is kissing the ring.
“Unblock, unblock,” he neighs manically, dystonic and ketamine-eyed, “free the shit, deregulate, privatise the ass-et.”
“Ooofaaargh, it’s not working, lad,” grunts Orange Don, living with obesity.
“JD get your vet-gloves on, boy,” whinnies Elon, ketamine-soaked, “time for a manual jobbie…..”
If deregulation’s good for the privateers for maximising efficiency and productivity, then why not the same for the NHS? What’s good for the goose is…etc etc
Reduce the heavy load of CQC, annual appraisals, mandatory nonsense and abused NHS complaints and GMC procedure – BS admin jobs paid for by the taxpayer and Drs.
This is disgusting. ALS trumps BLS anytime. This is what happens when a profession is held by dog catcher poles. GPs are treated like naughty school children. Yet GP’s refuse to strike to improve their conditions. You have to get together to change things for the better. No other professional is humiliated like this.
It would be interesting to know just how many GPs have been driven to early retirement by the appraisal process. I know I was. Mindless demeaning demands that do nothing to show how caring you really are.
Re NRowell, I know many GPs who packed it in a decade ago in their 50s due to annual appraisal.
When they rowed back on the petty points and evidence gathering before & during the Pandemic we at least had a compromise…..it was still an utterly useless and futile box-ticking exercise, but the savvier GPs knew how to manipulate the nonsense (PDPs you had to any way, cut & paste some BS drivel from previous appraisals, exaggerating each and every practice meeting into a learning experience, and most of all hoping for an appraiser doing it for the dosh who equally knew what a farcical waste of time the whole pathetic process was).
But the wheel turns, and various NHS nobodies with meaningless jog titles need to justify their existence, so slowly but surely the onerous red tape BS is sneaking back into GP appraisals.
Well, if you want to push out the highly experienced dinosaurs, this is the ideal way to do it.
There used to be a question on the Manchester GP appraisal form at the end which asked ‘are you honest?’ Tick yes or no . What a waste of ink
Ahhh… CQC’s new motto… S.C.R.E.W-U
Safe.Caring.Responsive.Effective.Well-led… Understanding
Appraisal appears designed to encourage people to exit GP long before they might otherwise have chosen to.
If there is any evidence that Appraisal process has improved Practice then it is extremely well hidden.
However a small but significant number of people benefit, particularly appraisers, and benefit enough from being not to work that abolishing the system would take significant courage – not a characteristic widely found amongst politicians, medical or otherwise
That red tape wasn’t trashed, it was recycled. No longer a brief, cosy fireside chat, but more my feet turned towards the coals for a couple of hours. I’m blaming the process – not Quasimodo and his minions in red gowns.