Dr Copperfield warned us about the Care Quality Commission (CQC) with words of wisdom back in August 2012. His prophesy has now become reality and is hitting us in the face; in fact it is getting so far up my nasal passages, it has practically hit cerebrospinal fluid.
Documenting policies and procedures in the name of patient safety has become bread and butter work to GPs, and it is more exhausting not to conform than to tick the boxes and move on. Like the European Working Time Directive it is probably open to interpretation, but most PCTs seem to be going for the hook line and sinker approach anyway.
The time and expense of the regulations, just when we are trying to save millions for the NHS, and coping with the massive reorganisation, seem to hit a raw nerve. We’re already busy preparing for revalidation, and the new contract has us doing back-of-a-napkin calculations to see whether we’d be better off giving up our surgery to become salaried doctors. We don’t need another headache on top of those.
It might be that we’ve lost our sense of humour, but some of the diktats which have reached my surgery are beyond a joke.
For example we can’t have toys in the waiting room or consulting room unless they can be wiped. Books are also thought to be dangerous. I wonder how many children have developed septicaemia from touching my treasured plastic crocodile. I have insisted on keeping my toy basket, which provides an essential part of a decent consultation with children. Besides, which member of staff should be deployed to wipe said toys?
Another PCT principle demands that every member of staff in our practice, including receptionists, receive a list of online learning requirements. At the last count this was 23 hours of modules on topics as exciting as ‘Handling of NHS Records’ and the only way to achieve this is for staff to have allocated time during the working day. It doesn’t take a lot of mental maths to work out that this is a lot of time. The GPs, of course, are invited to indulge in this leisure activity when not at work, making for several thrilling Saturday afternoons. And, oh yes – this has to be done every year, just in case we might forget which colour of bin in which to hurl the rarest type of hazardous waste. I can’t count the hours I’ve spent reading about manual handling, fire safety, infection control, and equality and diversity, followed by assessments in which (for example) you have to know that it is acceptable to describe a patient as an ‘older’ person, but unacceptable to call them old.The certificates can only be printed when you have passed and, if your mind wanders at any stage during the assessment and you ‘fail’ it, you have to take it all over again.
I would love to know who dreamt up such rules as, not allowing perfumed liquid soap in soap dispensers. We happened to have invested in a large batch of mildly aromatic blue liquid soap, which was duly threatened with a one-way ticket to the bin (I wonder which colour bin?). When I enquired about the threat to Health and Safety from this mildly-scented soap, there seemed to be no answer.
Unfortunately, being bemused and baffled by the logic of some of the regulations does not solve my problems. Sometimes I can’t help wondering why we have agreed to them. Boris Johnson’s description of members of the London Assembly as ‘great, supine, protoplasmic, invertebrate jellies’ might equally apply to doctors in their response to CQC and the creeping, dictator-like imposition of daft PCT rules and regulations.
Perhaps Dr Copperfield’s suggestion that we boycott the CQC would galvanise the whole profession into action. We ought to stick up for ourselves and for what really matters, which is looking after the patients.
Dr Fiona Cornish is a GP in Cambridge and chair of the Medical Women’s Federation.