Pick yourself up, brush yourself off, start all over again.

I have been pondering what people might be interested in hearing about and took some advice from a younger patient who said "just write what you are thinking". That seems more than a little unsafe to me as most of my thoughts at present are around frustrations with the quality of care we are able to provide for our patients and the numerous barriers and hurdles some of our patients have to overcome to get good care. All around me I see people trying to delivery a good service in the face of reorganisation, lack of funds, poor communication and mounting bureaucracy. All around me I see patients not receiving the care they deserve.

Don't get me wrong it isn't all the fault of others - sometimes it is us that gets in the way of a smooth pathway. For example by sending a Bromley resident to a Croydon service or sending a Croydon resident to a Croydon service which they are not entitled to because their GP has a Bromley postcode. Sometimes our staffing levels are too low and we cannot deal with our problems and queries as fast as you (or we) would like. Sometimes you cannot see the clinician of your choice. Sometimes we have forgotten to share with colleagues changes in services that we have uncovered so they cannot take the quickest route to getting a patient treated. We try to meet regularly formally and informally daily to ask each other's advice, to share and  solve problems and iron out frustrations. We apologise for those times when it does not work and try to learn from them.

Today we had most of the computers in the practice upgraded in preparation for a software upgrade to the clinical system in the autumn. I am sure anyone who attended the surgery today did not receive the best service but I hope that soon they will benefit from today's confusion. (Just to make it more fun one of our phone lines was out - so the telephone engineer had to work around us , the IT team and all the boxes and hardware).

One good thing came out of having the IT team captive for a day - we might soon be able to allow patients to register with the practice electronically, which will improve access for some prospective patients at least.

It looks as if the premises expansion is a dead duck, though we are having one last attempt at resuscitating it! We are trying not be too miserable or angry about it but all feel pretty let down by the process and the lack of anything other than verbal support from the powers that be. As with all knockbacks, you have to dust yourself off, get up and start again so we are looking again at what the alternatives might be and your ideas are welcome.

This has been a mixture of a rant and a ramble. I will need to post more frequently but also more concisely.
Finally what about the patients opinions and feedback - well I hope to have our first online survey up on the blog later this week.