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Please, just let us get on with it

I fear I’m on dodgy, politically incorrect ground here. But if you’re a one-legged Rastafarian transsexual, your practice needs you. Or rather, my practice does. Because last year the suits refused to cough up some Patient Reference Group dosh on the basis that we hadn’t tried hard enough to make our group demographically diverse.

So we’ve been racking our brains to conjure up potential minority-group representatives on our list, to avoid our PRG seeming Rastaist, leggist or transsexist. I can’t figure out whether this is demeaning to me, my patients, or both.

Fortunately, we’ve had other distractions. Finding consenting patients for multidisciplinary team meetings, for example. I’ve forgotten where this particular gem originated, but I know it involved the letters ‘Q’ and ‘P’ and the possibility of us re-earning money we lost when some other initiative labelled with ‘Q’ and ‘P’ was discontinued.

It was only when we started these meetings that we discovered the patients need to give ‘consent’. Yes: we have to phone them for permission to discuss their case with other health professionals in meetings which are convened solely to improve care, optimise social input and reduce the risk of hospital admission. Because, obviously, not everyone would want that.

So thank God for yet another distraction: the good old CQC, with which I’ve been in regular contact of late. Apparently, local practices have recently been living in fear of a clip from a clipboard for re-using a bronchodilator spacer (washed, obviously), when performing spirometry. That, the rumour went, was a CQC-igniting no-no: cue panic among the nurses. Many emails and phone calls with a nice CQC lady later – perhaps helped by a back-of-a-fag-packet calculation demonstrating that a new spacer per patient would cost a cool £7m per year nationwide – and we were told that we could, er, breathe easy; it’s okay just to give the spacer a scrub.

And what’s the common thread? Well, not so much a thread as a noose. Because that uncomfortable hypoxic feeling is your practice being throttled by micro-management.

I might not think that PRGs, MDT meetings and the CQC were such bad ideas if I didn’t have to get so bogged down demonstrating and justifying what I’m doing rather than just being allowed to get on and do it.

All of which amounts to a desperate plea. Currently in the pipeline is the biggest, baddest DES we’ve ever seen: the unplanned admissions enhanced service. This has the potential to eat general practice whole. We could be taken to new lows in administrative stasis, nightmarish bureaucracy, interminable meetings, pleas for payment and feelings of utter futility and despair.

Please, whoever’s job it is to dream up DES specifications: give us the money and let us get on with it.

I guarantee it’s more likely to be a success that way.


Dr Tony Copperfield is a GP in Essex. You can email him at and follow him on Twitter @DocCopperfield.