Fascinating to watch a radical idea evolve, isn’t it? Take the concept of capping workload, the origins of which can be traced back two years to the primordial soup that was the GPC’s Urgent Prescription for General Practice. This has now developed into a document, ‘Workload control in general practice – ensuring patient safety through demand management’.
Trouble is, my fascination has turned to incredulity. And that’s because, while full of words which are worthy, the ones this document prompts me to write include vague, muddled, unrealistic, amateurish, complete, utter, dogs and dinner.
I genuinely wanted to be impressed. Because I do want to Control Workload, Ensure Patient Safety and Manage Demand: if I do all that, there’s a glimmer of hope that I might reach the finishing line of retirement with my psyche, my soma and my medicolegal record intact.
But if this is salvation, God help us. Any sense of clarity stops with the title. Thereafter it’s a mash-up of half-baked unworkable ideas broken up by some meaningless graphics. By page six, the tone has shifted from tentative notions of appointment, hours or list size caps to an acknowledgement that workload restriction is a slippery concept best discussed in the abstract, giving the clear impression that the author is quietly trying to back out of the project.
Apparently, the papers will be interested if we’re on red alert
By the time you read about those mythical hubs – requiring ‘Sufficient recurrent funding’ and being ‘Servants of practices’ – and discover that the solution for rural practice is, get this, an ‘allowance’, you can actually hear footsteps running from a car crash.
Only when you reach the denouement about needing to define some lame-brained OPEL alert system, just like those proper doctors in hospitals have, do you realise that the whole point of this exercise is simply to give GP workload some media clout. Because, apparently, the papers will be interested if we’re on red alert.
Maybe. For one day. But my standard workload is around the 41.5 patient daily contact average recently and widely reported, and according to the BMA’s FRAX-style at-a-glance chart, that puts me firmly in the red zone. Every day. Which, by definition, isn’t news.
But let’s be fair: the Workload Control project is obviously a work in evolution. Trouble is, by the time it’s actually crawled out of the sea, we GPs will be extinct.
Dr Tony Copperfield is a GP in Essex