Tidying up some papers, I came across an article I had torn from the April 2016 edition of the BMJ: https://www.bmj.com/content/353/bmj.i2207
I had meant to show it to our son, James who, three months earlier, had entered Britannia Royal Naval College as an Officer Cadet. Reading it now, it seems to be more pertinent to myself and my colleagues, than to James who, happily, is thoroughly enjoying his career.
Under-investment, ever-increasing workload, increasing rates of mental illness and burnout … these fuel the recruitment and retention crisis, that in turn increases the workload of the remaining GPs …
… it’s a vicious circle.
No wonder then, that morale in General Practice is very low:
https://www.independent.co.uk/news/health/gps-nhs-two-in-five-plan-to-quite-survey-exeter-south-west-crisis-haemorrhaging-doctors-a7679166.html
Richard Jones’ article describes how life aboard a Royal Navy warship places the morale of its crew at the heart of all that is done: the decisions that are made; and how leadership, communication, caring for people, safety, training, and a clear sense of mission all play into the morale of the crew.
I recently agreed to relinquish my Lead GP role, now that my retirement is only a few months away. For me, the most important aspects of leadership are communication and engaging with all members of the team. So, I spent my Lead GP session getting to know and support the doctors, nurses and ancillary staff in the three other surgeries that had merged with Brune Medical Centre, to form The Willow Group. Mindful of the contagion of negativism, cynicism and demoralisation within an organisation, and that “…a leader with low mood can have a negative effect,” I just hope that any benefit from my leadership approach has not been negated by my time off with work-related stress.
Recognition of the inextricable link between morale, performance and safety, is the hallmark and focus of leadership in the Royal Navy. Richard Jones asks: “Would a healthcare manager ever consider morale when making a decision?” The NHS has certainly espoused leadership development, but its leaders and managers can still learn a thing to two from a Navy warship in giving equal weight to morale and operational capability when making decisions that affect the workforce.
The NHS can certainly learn a lot.
Even those in the RN feel more could be done to boost morale. But compared to the efforts I’ve seen within the NHS they are miles ahead.
G
Hi Gavin,
Hope you are keeping well. We really must meet up and catch up when you’re free.
Just to let you know that the blog is up and running on a new server. Just type talesfromtheboatshed into Google and you will access the blog. I’m not sure that you can register for notifications at this stage, but if not I will ask Steve to see if that can be arranged.
Best wishes
Stuart
Interesting. Only yesterday (25 October) I went to make an appointment with our GP – not possible until 9 November. However I picked up a piece of paper proclaiming the ‘new extended surgery available’ – Monday to Friday now available 6.30 to 8.00 pm. Saturday 9 am to 1 pm, Sunday 10 am to 2 pm, and I still can’t see my doctor until 9 November.
Hereabouts, and certainly with us, the wait for a routine appointment is four weeks. We open up appointments four weeks ahead. If we opened up appointments two months ahead, the wait would be eight weeks! GP Extended Access appointments are going unbooked because their availability is not widely known.
Such is the demand, such is the supply and, in the final analysis, it’s all down to the shortage of GPs, the disparity between supply and demand. I feel very conflicted: on the one hand, relief at stepping out of the situation, out of the system that led to me becoming so unwell, and excitement for my future plans; on the other hand, guilt that my early retirement will have a severe impact upon my close colleagues … that my departure is contributing to the very problems that led to me becoming overwhelmed by the workload in the Practice.
When something cannot wait for a routine appointment, the only alternative is a urgent/“emergency appointment.” However you try to match demand against inadequate resources, however you try to slice it and dice it, the system is under great stress and, in an increasing number of Practices, overwhelming stress.
What is needed is a restoration of the historic 4% annual growth of healthcare expenditure, a restoration of the previous share of NHS expenditure spent on Primary Care, a rethink of the pension reforms that incentivise early retirement, and urgent steps to improve the morale of General Practitioners … making them feel valued, respected and either making Partnerships profitable and less risky, or creating a salaried model that is attractive to upcoming doctors.
In the meantime, I advise anyone to take advantage of GP Extended Access, until its availability becomes common knowledge, and the slots are just as difficult to get as those in normal hours.
Good luck!
Stuart