Steve Donlan, Co-chair of the Practice Management Network and Management Partner at Endeavour Practice, discusses the pressures practice managers and staff are facing during Covid-19 and what the solution is to operating a practice in the current and future climate.
On Thursday, we are discussing the additional roles that my partnership would like to see procured or employed through my PCN in 2021/22. It should be the icing on the cake; we went through an administrative merger a few years ago and worked hard to recruit four part-time salaried GPs and a nurse practitioner in less than two years; before Covid hit, it felt that we were appropriately staffed. At last.
But that was then. Now, of course, everything is taking so much longer; the volume of appointments per session has been inevitably curtailed whether it’s down to the higher number of telephone consultations (as opposed to triage), e-consultations, video consultations or simply battling with PPE requirements.
Meanwhile, we are starting to gear up the services that we had postponed owing to the pandemic. I am sure that October will witness the beginning of our LARC clinics for example; a service which is particularly poorly funded in normal times, but the increase in time each consultation is going to take, makes it feel even more like an act of benevolence. With a very young, deprived population, however, we are loathed not to provide this service as we know the risks that such a vacuum in provision would create. I satisfy myself that this clinic does generate some income and it is replacing a session of the daily GMS grind which of course does not provide any additional payment.
It was a godsend in August, when both practices in the partnership became training practices and for the first time ever, we had four registrars across both sites. Before March, we would not have been able to accommodate them all. I would have turned one away. It was only because I have two shielding clinicians working a total of eight sessions per week from home that allowed me to squeeze an extra pair of hands into the building.
And then the penny dropped: whilst we continue to live in our inadequate 1970s accommodation, some members of the team will have to work from somewhere else. If we don’t think that some of the new roles we could gain through PCNs are well-suited to remote-working, then someone who traditionally works at the practice already will need to work remotely in order to create the space.
If this is to be the case, then our attention turns to bringing the IT requirements for general practice into the 1990’s (as opposed to the 21st Century). Laptops are not just a temporary fix to get us through the pandemic; they are essential pieces of kit to enable us to meet our GMS contract. They need to be included as part of a standard package of provision for which practices/PCNs do not receive a massive annual licence and support bill each year.
So, Mr Hancock, I am prepared to cancel my demand for a Tardis… but half a dozen laptops would be nice.