While on call recently, I had to request something I’ve never done in my 18-year career. I had to hit this bizarre metaphorical red button to alert our CCG of the significant stress that the practice was experiencing.
This button, known as OPEL 4, represents the highest escalation level and stands for Operations Pressure Escalation Level, which is a method used by the NHS to measure the stress, demand and pressure that different providers within the system are under.
In normal non-management speak, we had ‘significant unexpected reduced staffing and increased demand, which was compromising service provision/patient safety’.
Although this system has been operational in trusts for around six years, it has recently been highlighted as one of the case studies in the Fuller Report.
But in my under-doctored and socio-economically deprived practice where one GP serves 2,500 of the populace, what exactly was the impact of triggering this alarm in practice?
Well… nothing, to be fair.
Although triggering the alarm wasn’t nuclear in terms of impact (think damp squib), it did somewhat signify the beginning of the end in terms of my will to live that day. I had 145 patient contacts – yes that’s right, 145 – and clearly well above the BMA guidance for safe working.
No cavalry, not even a CCG phone call to check in – just a couple of exhausted duty GPs at the end of a very long day.
And yet similar stories are reverberating around the country, with GPs lamenting and posting their traumas on social media platforms. But here we are.
Regenerate, revive, rebuild, build – can we fix it? Whatever slogan we choose to embrace, we all acknowledge that things need to change to ensure our very survival. But what do we do when even our trusted elected leaders, who have been placed at the helm to help reform aren’t immune to the ever-increasing toxicity that’s seeped its way into the fabric of many institutions?
We are as a profession deflated, denigrated and under attack. Public opinion of us is now at an all-time low.
The truth is, there is no revolution until we start with a revolution of our own, and, more importantly, institutional behaviours.
So, what on earth are we waiting for? We have literally nothing left to lose.
Dr Margaret Ikpoh is a GP partner and trainer in Hull