Collective Action Outlook – Rota Coordinator
I joined Middlewood two years ago, after working in secondary care for 15-years, almost to the day. Working in a hospital Trust was a busy and pressure-filled environment, and the job was often faced with challenges systemic of the wider NHS: lots of red tape, long patient waiting times and limited funding.
Little did I know, those ‘over the fence’ in General Practice were hampered by even more restrictive funding cuts and a workload that was growing by the month.
I joined the Middlewood as a Rota Coordinator, and it’s my role to manage doctor’s and nurse’s leave, and ensure we have enough clinicians in our four surgeries to take care of the patients of Bollington, Disley and Poynton.
Moving around members of our clinical team to fill all the required positions can often feel like a game of chess, only you’re starting somewhere in the middle of the game, when you only have half your pieces left! It can be a challenge, but one that I relish.
Managing the care of 35,000 patients takes some serious coordination, and even at a large and robust organisation as Middlewood, having enough staff to do everything (whilst also giving everyone the time off that they need and deserve) is difficult.
Upon walking through the door at Middlewood, even I, as an experienced NHS employee, was taken aback by just how much my clinical colleagues were required to do on a daily basis. Alongside their full surgery (16 patient contacts in the morning and again in the afternoon), GPs were squeezing in patients who walk into the surgery with urgent issues, scheduling important meetings to coincide with lunchbreaks to save time and going to visit housebound patients on their way home from a 12-hour day.
On top of looking after their patients acute and long-term needs, GPs were helping manage specialist conditions, since consultant waiting lists had grown too long and patients couldn’t afford to wait for their next appointment. Our doctors were seeing patients who had just had surgery, writing FIT notes to extend their time off work and give them enough time to heal. I was seeing patients just out of hospital being booked in for follow up appointments with their GP, having been advised to “see their doctor in a week to make sure things are going well”.
“Wait – aren’t those things that should be done by hospitals, though?”
Yep – you’re completely right – all of this was extra work, on top of what they’re expected and paid to do. Yet there they were, doing all those things, regardless.
The level of dedication was, and is, inspiring. But while I was impressed by the level of commitment, I couldn’t help but wonder how sustainable it was, and what it must be taking to achieve day-in and day-out.
“If there’s all that demand, why aren’t you hiring more people?”
It seems like a simple question and a ready-made solution to the workload – so why not just hire more staff? Well, this is when we get back to the red tape and the lack of funding.
Overall funding to General Practice hasn’t kept up with the rate of inflation in recent years. This means that Partners have the same amount of money to run their practices, while the costs associated have all vastly increased.
Funding has fallen so far behind that the British Medical Association (BMA) recently polled their members to see how GPs nationwide felt about the situation, and the results are eyewatering.
99.2% of GPs who voted felt they needed to reject the most recent GP Contract from the Government and NHS England, which saw 1.9% increase in funding, despite the rate of inflation being 3.4% at the time. Rather than a funding increase, this new contract was realistically asking General Practice to work with 1.5% less funding than before!
Despite the overwhelming vote against it, the new contract would be imposed upon GPs anyway. This decision led to a further ballot, where 98.3% of GP voters said they supported collective action – something entirely unheard of in primary care before.
You’ll likely have seen news reports or social media posts about this collective action, painting this decision as “greedy GPs threatening to strike for more pay”.
The recent vote in favour of collective action is not about GPs striking because they want to be paid more. More accurately, the vote is about General Practice agreeing that the ‘extra things’ need to be scaled back, pleading for funding that’s desperately required for us to keep doing things safely and effectively. And while having enough staff plays a huge part in that, funding comes down to much, much more.
Of course, we need to hire doctors to diagnose problems and prescribe medicines, but we also need to pay for gas and electricity to keep our surgeries warm and well lit.
We need trained nurses to help manage long term conditions like diabetes and COPD, but we also need the funds to buy medical supplies like vaccines, syringes and dressings.
To offer the very best treatment, we need experienced physios and mental health practitioners to offer specialist advice, but we also need up-to-date IT equipment and software to manage patient information quickly and securely.
The costs of maintaining a safe and effective general practice go beyond GP wages, and the agreement for collective action is a cry for help from the primary care sector. Middlewood is doing everything we can to provide safe and compassionate care for our patients, and we’re proud to deliver a service that 95% of our patients rated as ‘Good’ or ‘Very Good’ over the past year.
We understand that all the talk of ‘collective action’ and ‘strikes’ can be unsettling, but we want to assure you that Middlewood has patient care firmly in mind with their decision making. I’m not a GP, or even a clinician, but I couldn’t agree more with my GP colleagues taking action to secure more realistic funding to support our services and our patients.
So, until that funding is secured, I’ll gladly keep playing chess with our clinical rota. And rest assured, every piece on the board is working incredibly hard to do their best for you and yours every day.
Drew Sherratt
Rota Coordinator