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In the consulting room: compulsive lying


Blog headlines

  • ‘There is nothing so practical as a good theory’
    16 September 2021

    The Networks blog this week comes from the Staff College: Leadership in Healthcare (Staff College) is a national charity dedicated to promoting great leadership for the public good.

  • Reflections on a ‘new’ NHS and its impact on general practice
    10 September 2021

    This week’s blog we are sharing reflections by William Greenwood on the direction for the health service and potential impact on general practice.

  • When facilitation could turn into mediation
    3 September 2021

    Requests to attend a meeting, to help find a way forward, to help with planning, to redesign a care pathway, and numerous other reasons are not always what they seem. Sometimes you will be asked to facilitate, or just asked to attend. What then happens in the room may not be the meeting that you are expecting. Other situations, such as tensions between practices, departments or teams may give a more obvious sign that what is needed goes beyond just attending or facilitating a little.

  • Population Health Management?
    26 August 2021

    One of the frequently heard phrases of the moment is population health management – but what is it and does it work. The blog is from a longer article by Monica Duncan exploring the topic.

  • The future must be primary care
    19 August 2021

    The blog this week is by Professor David Colin-Thomé, chair of PCC.

  • Preparing for winter 2021/22
    13 August 2021

    One of the hottest days of the year saw people from practices, primary care networks (PCNs) and federations gather to start to think creatively about managing their winter pressures in this session hosted by PCC and the NHS Confederation PCN Network.

  • Building the collaboration
    5 August 2021

    Prior to COVID-19 primary care network (PCN) community pharmacy leads (representing a group of pharmacy contractors in their locality) were starting to contact the clinical director for their allocated PCN to discuss how pharmacy services could develop and adapt to help address community health needs.

  • Audit into action… with a pandemic thrown into the mix!
    29 July 2021

    A blog from the Clinical Leads for the National Audit of Care at the End of Life (NACEL).

  • GP partnership uses new video to highlight benefits of its merger-led transformation
    23 July 2021

    An East Cheshire-based GP practice, the Middlewood Partnership, which formally merged in order to successfully transform its clinical and business models, is sharing insights, via a new video, with colleagues across the health and social care sector.

  • Early evaluation of the Children and Young People’s Mental Health Trailblazer
    15 July 2021

    The Birmingham, RAND and Cambridge Evaluation Centre (BRACE) is funded by the National Institute for Health Research to conduct rapid evaluation of promising new services and innovations in health and social care. The BRACE Rapid Evaluation Centre and Policy Innovation and Evaluation Research Unit have published findings from the early evaluation of the Children and Young People’s Mental Health Trailblazer programme.

  • Learn from reflection
    8 July 2021

    We are sharing an article by Helen Northall, chief executive, PCC this week on learning from reflection.

  • Link of the week: National Thank You Day
    1 July 2021

    This week we are featuring National Thank You Day.

  • North East Essex integrated discharge single point of access - implementing the Coronavirus Act 2020 and Covid-19 hospital discharge service requirements
    24 June 2021

    The blog this week is from Frank Sims, chief executive of Anglian Community Enterprise and shares learning on collaboration and redesign to support hospital discharge.

  • Helping your patients making an informed choice: Medical or Surgical abortion?
    17 June 2021

    This week the blog has been submitted by MSI Reproductive Choices UK and is about supporting patients to make an informed choice based on NICE guidance.

  • The potential for case finding patients with cardiovascular disease in a dental setting
    10 June 2021

    The blog this week is by Wendy Crew, PCC adviser, considering the opportunity to case find patients with cardiovascular disease in a dental setting.

  • Using population health data to inform ARRS recruitment
    3 June 2021

    Funding for the additional role reimbursement scheme (ARRS) has increased nationally from £430m (2020-21) to £746m max. (2021-22) with an allocation available for each primary care network (PCN) depending on the size of the population it covers. Clinical commissioning groups (CCGs) draw down the funds but only as new roles are recruited within PCNs. PCNs are therefore being strongly encouraged to make use of their ARRS allocation to ensure people in their neighbourhoods benefit from the funding available.

  • SHAPE Atlas mapping tool
    27 May 2021

    As the themes of the NHS Long Term Plan start to become reality through plans for legislation to support integration, we need to work out where the best place is to deliver services.

  • Cancer Care Map
    20 May 2021

    The blog this week has been submitted by Robin Pritchard, co-director of Cancer Care Map. Cancer Care Map is a stand-alone, comprehensive, independent, free to use online directory of cancer support services in the UK providing verified and trusted information, regularly checked and updated and accessible to all.

  • Understanding and aligning link worker and community capacity building activity: A place-based approach in York and Wakefield
    13 May 2021

    The blog this week is by Sian Lockwood, chief executive officer of Community Catalysts.

  • Virtual group consultations and Why skip/send it to landfill?
    6 May 2021

    An article on group consultations that celebrates the patient perspective and experiences of receiving care this way from Alison Manson. Blog on reusing/recycling and saving money for a NHS Trust from Alex Ford.

Friday, 1 June 2018

In the consulting room: compulsive lying

In this week’s instalment of our fly-on-the-wall documentary about the working lives of doctors, an NHS finance director discusses a delicate matter with her GP

Doctor: What can I do for you today?

Patient: It’s a bit embarrassing. I’d rather not talk about it

Doctor: There’s nothing you can tell me that I haven’t heard before

Patient: You won’t tell anyone else?

Doctor: I’ve taken an oath

Patient: I’m worried that I’m becoming a compulsive liar. I simply can’t tell the truth any more

Doctor: I see. Why is that a problem for you?

Patient: I’ll be sacked if I tell the truth

Doctor: I find that hard to believe

Patient: No, honestly. I’m not lying – at least not about that

Doctor: Why do you feel the urge to lie?

Patient: It’s the only way I can keep other people happy – the chief executive, other members of the board, NHS Improvement, NHS England

Doctor: And you’d rather tell the truth?

Patient: God, no! The truth is far worse

Doctor: Do the people you’ve mentioned know that you’re lying to them?

Patient: Yes

Doctor: And they don’t mind?

Patient: No, they prefer it. In fact, they insist. They’re all doing it too

Doctor: Have you ever tried telling the truth?

Patient: I tried it last year. I said we couldn’t meet our financial targets. Everyone was furious

Doctor: Because it wasn’t true?

Patient: No, because it was

Doctor: What happened?

Patient: We didn’t get our transformation funding

Doctor: Which is…?

Patient: The extra cash we need to transform the balance sheet

Doctor: I see, so other people are rewarding you for lying? That’s very unhealthy

Patient: Maybe, but it’s better than being punished for telling the truth

Doctor: If everyone’s lying surely you have nothing to worry about

Patient: I’ll have plenty to worry about at the end of the financial year when the truth comes out

Doctor: Just tell them you were all in it together

Patient: The board will deny it. They’ll say the figures I gave them showed that everything was fine

Doctor: And do they?

Patient: Yes, but only because they told me to make them up

Doctor: So, what do you want me to do?

Patient: I hoped you could give me something for it

Doctor: I could give you the name of my accountant or a short course of anti-depressants

Patient: I think I need something stronger or I’m not sure I’ll get through next winter

Doctor: Did you have something in mind?

Patient: Ten million should do it

Doctor (writing prescription): Take this to the pharmacy. You should feel better in a couple of days

Patient: Is it a cheque?

Doctor: Yes

Patient: Honestly?

Doctor: No, not really, but I have other patients to see and your time’s up

Patient: Thank you for being so honest with me, doctor

Doctor: Not at all. Send in the next liar on your way out   

Editorial regulator: NHS Networks