Managing and reducing stress

Written by: Georgia Dossis

Stress serves the purpose of reacting and avoiding danger, which is great but too much can have a negative effect on you. Life is full of major and minor challenges and it’s completely normal to sometimes feel inundated with these issues.

According to Champion Health, one in 14 UK adults feel stressed daily and I guarantee if you ask your neighbour, your work colleague, a friend, or a family how they are, at least one of them will use the word ‘stress’ in their response.

Below are some suggestions on how to relieve and control symptoms when everything is getting a little bit too much:

-          Leave work at work. With the most common cause of stress being work related, I think one of the most important things is to leave work at work. I’m aware that not all job roles have this perk, but where you can you most definitely should leave work at the office. You psychologically associate your surrounding with your feelings. If you’re taking your work home you’re more likely to feel stress in your home and find it more difficult to switch off when you need to.

-          Be active. I can guarantee that this is the first thing you hear when you say that you’re stressed, and it often is the first question too “are you getting any exercise?” but they aren’t wrong. Exercise increases endorphins, which numbs pain receptors, allowing you to feel better and happier. Even if it’s a walk around your estate, getting movement in will reduce your stresses.

-          Take some time for you. Work holidays are given to be used. It would be unhealthy to work every single day of the year, no matter how much someone loves their job. Taking time off to catch up on you is not a bad thing. You can use this to get some of the life admin that you put off during the week done, take a holiday or even take a day to put your feet up.

-          Getting organised. By getting organised, you instantly feel better about the tasks that you need to do. Creating a to do list helps by having everything out of your mind, alongside being able to visually see what you’ve got to do.

-          Breathing and meditating. There are hundreds of apps and thousands of YouTube tutorials that can help with this. By focusing your attention on breathing it clears your mind of all the tangled thoughts. Meditating not only strengthens areas of your brain responsible for learning, attention and memory but also helps calm down your sympathetic nervous system. This improves your heart rate by slowing it down and causes you to feel more relaxed.

-          Activities. Whether it be apple picking, going shopping or using an adult colouring book, doing something you enjoy will allow you to take your mind away from what you’re focussing on that’s causing you stress. Colouring or reading for example help relax the fear centre of your brain which is what cause you to become calm.

-          Keep a journal. Journalling can allow you a safe space to express how you feel without fear of judgement. Here you don’t have to worry about grammar, punctuation, or spelling, just write whatever comes to mind.

-          Healthy Diet. There’s nothing more tempting when your stressed to eat badly, which is normal, and variety is good. But a healthy diet is key to keeping your body regulated and happy. We’ve all heard the term ‘hangry’, eating good healthy foods will help eliminate the ‘angry’ part.

Although stress is unavoidable it is definitely controllable, you just need to find what is right for you. Keeping stress at a manageable level is key to your overall well-being.

The IT man cometh

Written by: D. Nedry

I don’t know about anyone else, but I am getting more and more frustrated with the IT ‘support’ provided to our practice.

I can never get hold of anyone when I need to, if I desperately need something for the practice like a replacement for a 15 year old printer I am told that there are none available and when I need an engineer to come to the building they seem to be as rare as hens teeth. And yet, for no immediately obvious reason, they keep turning up at the practice unannounced to replace equipment that seems to be in perfect working order.

I’m not sure if this is something local or a problem across the country, but decisions about IT budgets and spending seem entirely illogical to me. But then, it’s not my business to know how those budgets are allocated and to be frank, I have enough to think about without pondering this techno-puzzle but what drives me absolutely round the bend are the things that we, or I must do to enable this bizarre cherry picking of IT needs.

For example, last week I had to check every single monitor in the practice for a particular model number and screen size, and that is no mean feat. We have a lot of rooms and a lot of computers, and the part about it I couldn’t fathom, was why I was doing it at 7pm on a Monday night? Why was I frantically rushing to get this done when it really wasn’t a top priority task for my practice?

I realised that actually I was making a rod for my own back by agreeing to do it in the first place. At 7pm on a Monday I should be at home with my family (probably with a glass of wine), not running around with a clipboard and a set of keys dashing past the cleaners to get in and out of rooms. So, I’ve decided on a new approach.

If something is so important that IT absolutely positively need it doing ASAP/yesterday, then quite frankly they can come and do it themselves. From this point on, I’m just refusing to jump to IT’s schedule because actually, I think that getting on with my own day job is more important to patients than replacing an old monitor that works just fine!

I am sure I will make some enemies in the IT department, but with everything else we have to juggle at present, I don’t really care. I care about my practice, my team and our patients, and if IT don’t like it, they can stick it up their modem.

I think we should all adopt this attitude and make our IT departments work for us.

And so today, when I received another email from IT asking me to look for a piece of equipment at our practice, I asked them why they don’t have a record of where their equipment is allocated, and why they couldn’t send someone out to look for it themselves instead of wasting my time and the time of the practice team.

There was silence for a while…but eventually I had this reply…

‘We’ll be on site tomorrow’

It’s a little win sure, but it’s saved me a bit of time today and surely in these ever changing, completely bonkers times we need all the little wins we can get.

Why we should be composting

Written by: Georgia Dossis

By now you’ll have seen all the headlines and David Attenborough documentaries that hit us with the hard truths about becoming carbon neutral before 2030. There are so many ways to do this, whether it be using green energy to power your house, recycling, cutting down on your journeys in the car or even driving an electric vehicle, the list is endless.

But one really easy way in which we can reduce our carbon footprint is composting.

Composting is the natural process of recycling organic matter, such as food waste, teabags, leaves and food peelings.

What we don’t think about is that when you throw food waste away it ends up in landfills. Every 100 pounds of food waste that goes into landfills produces 8.3 pounds of methane, which in turn releases methane into the atmosphere trapping in heat and contributing to global warming.

This makes up for 8% of greenhouse gas emissions. It’s said that if every household in the UK composted their food waste rather than throwing it away it would have the same effect on greenhouse gases as planting 640,000 trees.

I won’t lie when I hear composting, I hear green thumb, gardener, or farmer. But you can do this in every environment whether you have a big garden, small garden, farm, yard or flat. Little kitchen compost bins are easily attainable and easy to use to turn your food to mulch and if you don’t have an arboretum to use this on, you can share it with neighbor’s or local farms through app’s like ShareWaste, which find people around you that you can give your compost to so that they can use it for fertilizer.

Whether you keep the little bin in the kitchen or outside is completely at your discretion but for such an easy way to reduce your carbon footprint, it’s definitely worth thinking about!

A Crummy Guide to CQC's New Guidelines

Written by: Georgia Dossis

In a bid to make the process easier for surgeries as well as fit into new guidelines, CQC have decided to change part of their framework on how they will begin assessing care providers going forward.

So far, they’ve explained that their five statements Safe, Caring, Responsive, Effective, and Well-led (SCREW) domains are staying, along with their four-point rating scale (Outstanding, Good, Require Improvement and Adequate).

However, they will replace their Key Lines of Enquiry, prompts and rating characteristics with new ‘quality statements’ to reduce duplicates in the four-assessment area’s and make it essentially easier for providers to follow.

To make their judgement consistent, their new framework includes the below six categories for the evidence that they will collect:

• people’s experiences
• feedback from staff and leaders
• observations of care
• feedback from partners
• processes
• outcomes of care.

The way that they will use their new framework, is that they will continue to use inspections via site visits so that they can get evidence to assess quality, use a range of information to assess providers flexibly and frequently (this is not tied to a previous rating) and produce shorter and simpler reports showing the most up to date assessment.

Which going forward means that providers can be clearer on what is expected of them from the assessments, the reports will be simpler to read and all in all will result in better quality patient care.

Nice little job in a GP Practice

Written by: S.Black

I’ve read a lot in recent years from practice managers who want to form their own professional body, it’s an interesting one as whilst I agree that we are a group of professionals and we should have some form of representation, I think that we will always come up against the same problem…a total lack of understanding of what a GP Practice actually is, and even less comprehension about what a Practice Manager does.

A good example of this is something that happened to me recently, when I (for my faults) attended an informal school reunion. At first it was all hugs and recognition, then came the standard questions;
Are you married?
Do you have children?
Where do you live etc. etc. until finally, we came to what could be the most boring question of all time…what do you do?
I cringe at this question as I don’t think the sole measure of a person is their occupation, and so when I was asked this recently, I began, ‘I work in a GP practice.’
 To which came the response (and not for the first time)
 ‘Oh are you a receptionist?’

The person I was speaking to knows that I’m not a doctor, they know I didn’t attend medical school, and therefore it’s interesting to me that the first place their mind went was reception. Now, before I continue let me state categorically that I was not offended by this question, and that I have more respect for our reception team than any other team in the practice. As far as I’m concerned, they have the most difficult job in GP land; it’s thankless, relentless, and woefully underpaid across the country. The reason I found it interesting, is that public perception of GP practices seems to be this; that if you work in a GP practice, you’re either a doctor, a nurse, or a receptionist…and nothing else.

GP land is like a hidden world that outsiders don’t understand; filled with challenges and triumphs that simply do not occur in other industries, even in other parts of the NHS. Forget anyone in the private sector if you’re looking for understanding because the fact of the matter is, practices exist on their own plains, and we must accept that the public simply cannot comprehend what we are dealing with on a day-to-day basis.

I remember, several years ago, a rep from a company coming out to our practice and making an offhand comment about practice managers never working full time, the implication from her tone being that PMs don’t really do that much. I was furious but being a relative newbie myself I kept my own counsel. I’ve often thought back to that day, and the fact that the rep professed to understand how practices work and to recognise the pressures we face, whilst at the same time openly criticising the fact that a practice manager didn’t work 5 days per week. I never told her that the reason the PM only worked 4 days a week was because she worked consistent 12 hour days, well over standard full time hours, doing most of her admin at home on her ‘day off’.

Which brings me back to my opening point. People, and by people, I mean anyone who has never worked in general practice simply cannot understand, comprehend or believe the work that we do. They do not understand the vast complexities of our targets, the way that we are paid, the structure of staffing or even the fact that we are essentially independent businesses and what we need to learn to accept is that they never will.

I know that people on the outside think I’m being dramatic when I explain my role, that it is business manager, HR manager, contracts manager, finance manager, IT manager, complaints manager, maintenance man, snow shoveler, staff counsellor and more all rolled into one. But it’s the truth, and other PMs will read this and nod their heads because undoubtably you too have seen someone glaze over when you try to explain exactly what it is you do.

So what can we, as PMs do about this?
Honestly?
Well, nothing really. Other than alter our way of thinking about it.

I refer to two characters from fiction to illustrate my point. Clark Kent and Harry Potter.

Let’s start with Harry Potter, it’s a nice easy analogy that we can all relate to. We work in a world that outsiders (let’s go the whole hog and call them ‘muggles’) simply do not understand. They don’t believe in it, they think it’s as simple as just hiring more doctors or just getting more receptionist and they have no idea that there is a whole world of practice staff working away unseen in the background; clinical coders, reports administrators, clinical administrators, medical secretaries to name a few. Until you become part of the mystical world of general practice you just don’t get it, you’re not in the club, because you’re a muggle, and we are magic.

In case you’re not a fan of the wizarding world, let’s take a look at the classic caped crusader instead, Clark Kent, who worked a normal job, and looked, from the outside, like a normal bloke with nothing special or interesting about him, until things went wrong and suddenly, he was ripping off his shirt, throwing off his specs and saving the day as Superman. As Clark Kent, he took none of the glory, and just did what he had to do until it was time to be his true self and save the day. He couldn’t tell his colleagues in the office how much he was doing behind the scenes, and although we as PMs can, it is pointless, so we don’t.

Why have I leapt to Superman you might be thinking?
Well, consider this…

When the pandemic hit all hell broke loose, and GP practices were being slated left right and centre. The government were chastising us for closing our doors…which was a load of rubbish in most cases, and criticising GPs and medics for taking government mandated precautions like reducing unnecessary F2F appointments to lower the risk of spreading the virus. We were openly criticised by our patients and received record numbers of complaints across the industry simply because we were trying to keep our patients and our staff safe. We were Clark Kent, beavering away in the background, working from home when suffering with covid ourselves and receiving no real thanks once the public became sick of clapping for the NHS.

But who was it who got the nation vaccinated? The mass vaccination sites? No. It was GP Practices. Like Superman emerging from the toilet cubical Clark Kent formerly occupied, we rose up as a group and facilitated the mass vaccination of the most vulnerable and at-risk groups in the country. Don’t get me wrong, vaccine sites did their share, but it was GP practices who ensured that the people who were at most risk were protected from the effects of Covid. And no one can ever take that away from us. We did it without fanfare, and then we did it again, and again, and we’re about to do it once more and no doubt there will be those who criticise our management of the vaccine programme this time round but who cares? They don’t get it. They’re muggles, and we are magic folk. They aren’t in the club and so they’ll never understand.

So the next time I tell someone where I work, and they ask if I’m a receptionist, or they make the classic comment ‘Oh, a nice little job in a GP practice’, I won’t flinch, or lose my temper, or even attempt to explain why they’re talking out of their rear.

Instead, I will simply smile and nod, and as they walk away, I’ll mutter to myself with a sigh and a shake of the head…’Muggles’