You probably realise by now that, after 27 years of practice, I hate pretty much everything. And recently, two of my most hated hates have joined forces, lifting me to new heights of hatred.
First, computers. Yes, that makes me sound like a cantankerous, prostatic luddite – but then again, I am. Actually, it’s not computers themselves I loathe, but the relentless computerisation of life in general and primary care in particular. You hate it too, don’t you? Just with fewer expletives.
Second, abbreviations and acronyms. Those used in GP training are the worst, designed purely to enable smug educationalists to have conversations that exclude normal people. It occurs to me that I probably hate educationalists, too.
But abbreviations in GP computing are nearly as bad. And this is where those two key pet hates collide. Take CQRS, for example. I say CQRS. But, more accurately, it might be GPES. Or GPET-Q. Or maybe HSCIC.
Whatever. Remember how CQRS was sold to us as an all-singing, all-dancing computerised service that would automatically collect our QOF and DES data, thereby ‘freeing up valuable GP and admin staff time’ to do proper GP and admin work like seeing sore throats of half an hour’s duration, and hanging on the phone all day waiting for an answer from a hospital secretary who, it turns out, no longer exists.
The only problem was that CQRS didn’t sing and it didn’t dance. Even now, more than two years on, we’re having to enter some data manually. Worse still, and this is what’s making me acute on chronically splenetic, CQRS/GPES/etc is transforming by stealth from friend to foe – from data spade to data spy.
For example, we now find ourselves having to enter returns on CQRS for the FFT fandango, with a zero score prompting possible ‘remedial/contractual action’. We also have to accept CQRS monitoring our alcohol-related risk reduction entries, meaning the switch from DES to contractual requirement is somewhat more onerous than we’d anticipated (check out the 20 associated codes and 25 separate ‘management information counts’ if you don’t believe me).
And there’s more. We’re now being asked to agree to CQRS number-crunching clinical information about serious mental illness and COPD – that was what the ‘Invitation to accept CCG OIS’ was about, in case you wondered. And just the other day, I got a email reminding me to sign up to CQRS dementia stats collection because, and I quote, ‘All practices are legally obliged to comply with this data collection, which has been directed by the Secretary of State for Health’.
See what’s happening? Micromanagement and big-stick policing have gone up a gear. Our contract is being deconstructed, and our clinical work dissected – but the associated CQRS police-state scrutiny is hidden behind software and acronyms.
I know it sounds like I’ve gone from burnt-out hateful to full-on paranoid. But that’s because we’re being watched. And they really are out to get us.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield
