When I was five I used to love asking my farmer uncle how he counted his sheep. “Count the legs and divide by four” he was sure to reply, and I was sure to giggle. Thanks Ray, for the laughter and learning you sparked.
Measurement, a kind of counting with maths, is a huge part of what we do and we are always trying to make it simpler and clearer.
The simplest, most important measure in general practice is demand – by month, week, day, hour.
Then comes the service response – how fast, how soon? That’s what matters most to patients. Why isn’t anyone else doing this?
Then comes efficiency – how long does it take to deal with all those demands? That’s what matters to GPs and staff – they want a reasonable working day, and without harming patients improving efficiency is the surest way.
All these are operational measures we derive on an industrial scale with minimal effort and immediate visibility.
So It grieves me to see hundreds of £k spent on fiddly little “improvements” which make no attempt to measure benefit for patients. They trumpet thousands of hours saved – which turn out to be approximately 17 minutes per GP per week.
It grieves me to see the vast expense on poor substitutes for measures, postal surveys with small samples and smaller response rates, reported months later. Counting legs.
It grieves me to see the BMA making threats to close GP lists, unable or unwilling to frame questions of capacity in terms of efficiency.
When you make a step change in efficiency, lots more becomes possible in ways we can’t measure with numbers.
Read in Pulse how Dr Steve Edgar describes “Taking back control”, using terms like autonomy, mastery and purpose, with time for the simple team huddle.
If you’re heading to the hills this week you’re sure to see a few sheep. Yan, tan, tethera…
PS Reminder of the poster study of online consultations at Concord Medical Centre. Another step on the efficiency road.