Happy New Year. And good riddance to 2013. For me, it’s been something of an annus horribilis. Demeaning fights to get paid, a torrent of abbreviated and acronymised torture (QOF, CQRS, AQP et al), Portsmouth sinking to their lowest ever league position and a Health-and-Safety-Gone-Mad-moment with the fitting of window-opening restrictors on our first floor consulting rooms, starving me of that glorious Essex vista.
Worst of all, though, 2013 was Year of the Complaint. Now, I’m certainly not of the ‘Every complaint is an opportunity to learn’ school of bollocks. But I’ve always had a pretty robust view on the subject, taking the pragmatic line that complaints are random and inevitable, especially if we’re doing the job properly – and that, for every vindictive troublemaker, there’s maybe one who might justifiably have made a fuss but didn’t.
Which is all very well when you only get one significant complaint every few years, as opposed to daily whinges about lack of appointments/parking spaces/antibiotics. The problem is, in 2013, I lost count: I’ve spent more time fending them off than I have seeing patients. So now I hyperventilate over every envelope headed, ‘Confidential, for addressee only’, and I’ve got the MDU on speed dial.
What’s going on? I’ve not changed my practice, and I’m no more stroppy than usual. And it’s my genuine belief that standards on Planet Primary Care are as high as ever – despite, not because of, CQC, revalidation and so on.
Yes, patient expectations are higher, litigation is on the rise, blah blah blah. But ’twas ever thus. Something else is happening. Maybe there’s something in the water. Maybe all that vitamin D we’re prescribing is stimulating a dormant retribution area in the brain. Or maybe it’s those bloody cancer campaigns. They give the impression that prompt diagnosis is as easy as chucking out a sloganeering headline. Which translates into the GP being incompetent, uncaring, or both if there’s a perceived delay.
And guess what? It’s going to get worse. We’re all accustomed to walking a medicolegal tightrope but, with the thumbscrews being tightened to cut referrals and slash admissions, we’re now doing it while someone hits us in the face with a plank. It would be a neat irony if the funds from the new unplanned admissions DES would cover the hike in defence subs, but they won’t, so it isn’t.
In the meantime, I’m grateful for small mercies. After all, a colleague of mine is facing a complaint heading all the way to the GMC. This has triggered a cascade of information requests culminating in NHS England sending him a letter from the ‘Poor Performance Unit’. And that, as he pointed out to me in a pause from punching the wall, is what hurts most: the implication that he’s a poor performer, guilty until given a chance to prove his innocence, regardless of 25 years’ unblemished service.
Now he’s angry and demoralised. So maybe those window opening restrictors aren’t such a bad idea.
Dr Tony Copperfield is a GP in Essex. You can email him at firstname.lastname@example.org and follow him on Twitter @DocCopperfield.