Meeting creep.

We here at ND Central used to once have proper Practice meetings. These meetings were when we the GP partners in the Practice met together with our practice managers and other staff (if required) at least once a month to discuss the Practice’s “business” which is providing healthcare for our patients.

For non-UK readers and for most in the UK who think that most GPs are employees of the state most GPs are “self employed contractors”. We are like self employed plumbers or builders albeit contracted to provide services to the middleman of the state called the PCT (Primary Care Trust) soon to be abolished with whom some of us hold a nationally agreed contract.

This means we have to provide certain core services but as professionals we have a greater degree of control and therefore freedom as to how we run our Practice (our business). This can result in innovation and excellence as some Practices adapt their services to suit their local population and its needs but the downside is that it can allow some Practices to slide if high professional standards are not maintained

In the old days practice meetings could last as little as two hours and were often held after hours which meant when the working day once finished at 18.00 Zulu we might get home at 21.00 Zulu after a full working day as well. Complex matters like what colour paint should we have for the window frames or when can we take leave during the school holidays were discussed or how many emergency surgeries do we need/want to provide.

During our training it was always said that GP Practices which had regular Practice meetings were the better practices as there was communication and hopefully Partner participation in the business especially if each Partner had a vote i.e. a democracy as opposed to Practices where the Senior Partner dictated everything. Such meetings were once business meetings and were short(ish) and to the point.

Under Za Nu Labour’s centralized Sovietization of the NHS coupled with their “command and control” policies of the (medical) professions, the team at ND Central have seen meetings increased in both in length, and in number, by imposition of so quality “targets” to tick local retards’ boxes and deliver bugger all health care.

We repeat deliver bugger all healthcare but increase medical arse time on seat doing sweet FA to tick someone’s box.

The military use the term “mission creep” for increased involvement in matters hopeless at the behest of interfering ignorant politicians and we would suggest the term “meeting creep” for something similar in GP land.

Lets us look at some examples of meeting creep that have been imposed from the local Soviet and discuss whether they achieve anything other than a box ticked. Bear (sounds like a Soviet bomber?) in mind these are just of few of the many add-ons imposed by local commissars over the last 13 years.

Let us start with the perceived need by local NHS retards, managers, sorry commissars, who feel that quality involves discussing every new diagnosis of cancer as a “critical incident”.

We feel, as simple grunts on the ground, the need for a huge Homer Simpson “D” word here and may unfortunately have to use a few choice grunt words in what follows for which we apologise.

Listen up f**kwit NHS retard managers sh*t happens every day in medicine but never in your offices for you never see patients.

Grunt rant over and apologies for the extremely rude grunt words. A few facts for your average NHS commissar/manager follow to compensate for our slight impoliteness but then you never deal with real patients just spreadsheets.

Cancer happens. It is not a critical incident unless you are one of those NHS managers who only look out a window on a Friday afternoon?

Why? Because if you didn’t do this on Friday you would have nothing else to do for the rest of the week. (Old medical joke re NHS administrators). Remember what do you call two NHS managers holding hands? A synapse.

Cancer happens it is unfortunately part of life and will kill up to a third of us. If it is missed, through negligence, then that is an INCIDENT but if just happens that is life.

So discussing whether John Doe who has smoked 60 a day for sixty years has got lung cancer will achieve what?

Nothing.

Now the tw*ts that think that this sh*te is important will think that this will make a difference. So Mavis 54 who does not smoke or drink has had 2.4 children who develops breast cancer because she is a woman who has a 1 in 9 chance of developing breast cancer is now a “critical incident” that we have to “discuss”.

Why? What does it achieve? Should we discuss gravity as a critical incident at each meeting because things fall off desks in NHS mangers’ retard offices and patients fall over and break bones? Gravity must be a tsunami of a mission “critical” incident to be discussed at each meeting in future.

Retardation extends even further in the NHS Soviet command and control structure as we now have to discuss as “critical incidents” something that never ever happens in life but is deemed “critical” to NHS managers’ existence the fact that patients do things beyond their limited comprehension and control and they eventually die. Death is now a “critical” incident.

Get the smelling salts out for Whilhelmina Bristlecombe who died peacefully in her sleep at 105 years of age and was subject to a post mortum by the coroner as the last GP to have seen her had done so 3 months earlier when she had been playing baseball and ran a homer with her great grandchildren and didn’t know why her doctor of 40 years was there.

Amazingly the post mortum showed she died of nothing more sinister than “Old Age” but this totally natural death is now a “critical” incident because at age 105 she died.

Why? What does it achieve? Should we discuss the weather as a “critical incident” at our next meeting because it rained?

The worst of all meeting creep add-ons are the imposition of attendance at practice meetings by members of the radical Al Qaeda school of pharmacy the pharmacists employed by the PCT. In the same way that a nurse can now do a doctor’s job on the cheap and people with no qualifications can play at being nurse’s PCT retards feel that a radical pharmacist can now educate doctors and make them perform better.

So many hours are wasted as these Al Qaeda trained pharmacists invite themselves to meetings and demonstrate how much work they do by displaying graphs from laptops for hours at a time. This is not about quality it is about saving the local Soviet money so they can employ more managers. The most recent innovation from the local Soviet who quote words like QUIPP but we think Jonathon Ross would pronounce it more accurately as CRAP is to substitute one non steroidal anti inflammatory drug (NSAID) for a cheaper alternative.

Now the idiots that have thought of this idea clearly only have memory in their computers for the more expensive NSAID appeared in the late 1980s and it became popular because it was much more effective that the one now being promoted by the radical pharmacists who are too young to remember the less effective older drug (they would have been in diapers and probably still are given what comes out of their mouths) and as they do not ever follow up patients for years will have no idea what works and what doesn’t but will happily dispense any sh*t (sorry another grunt word) for profit.

Still they are getting paid to waste doctor’s time by hijacking what should be business meetings about providing healthcare not saving money by the use of less effective drugs.

The increasing layers of retardation coming to GP land are like an atomic bomb. A small explosion in central government leads to a huge, expanding mushroom cloud of retardation that will engulf all in general practice for years to come.

This mushroom cloud of NHS retardation and meeting creep continues to expand, despite the new NHS reforms, and please do remember Marshal DC’s quote "We are not reorganizing the bureaucracy of the NHS, we are abolishing the bureaucracy of the NHS". We suspect that the mushroom cloud of NHS management, albeit in different guises, will spread NHS management to new, and as yet unseen, levels of meeting creep.

For surely we will have to now have commissioning meetings, budget meetings, referral target meetings, feedback from consortia meetings et al on at least a monthly basis and more so towards the end of the financial year when the money starts to run out?

Remember fundholding? No extra work involved in that policy, comrades was there ever? Anyone remember having practice meetings and then additional fundholding meetings. We all know that history never repeats itself.

Praise be to the Party for inventing Practice meetings that will result in GPs treating patients so much better by being in meetings all day. More meetings and longer meetings clearly means more, and better, hands on patient care.

The minutes will prove this for if you die when your GP was in a meeting your GP’s attendance at a meeting means you had true quality care for the meeting minutes will show this to be true. The “evidence” will show this to be true.

Quality healthcare is as we all know delivered by sitting on ones’ arse for longer and longer in meetings and avoiding patients. Just look at nurse managers.