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Solving doctors


Blog headlines

  • Cultural change at the heart of integrated care systems
    8 April 2021

    The blog this week, by Helen Northall, looks at the changes needed to make integrated care systems a reality.

  • Bluelight Cycling Club
    1 April 2021

    We are a cycle club that is dedicated to the Police Service, Fire Service , NHS, Coastguard, RNLI, Prison Service, NCA, Search and Rescue community and Armed Forces.

  • Enabling Integrated End of Life Care with a population data dashboard
    25 March 2021

    The guest blog this week is by Dr Karen Chumbley MBBS FRCGP MSc, North East Essex Health and Wellbeing Alliance Lead for End of Life Care.

  • The new proposed NHS legislation and where this fits in the jigsaw of changes
    18 March 2021

    In the blog this week William Greenwood, chief executive of Cheshire Local Medical Committee, looks at the implications of the White Paper on general practice.

  • Integration and Innovation: working together to improve health and social care for all
    11 March 2021

    Professor David Colin-Thomé shares his thoughts on the White Paper in this week’s blog.

  • UK’s National Health Service teams up with the Radio Society of Great Britain to improve health and wellbeing
    4 March 2021

    This week's blog is by Paul Devlin, Emergency Care Improvement Support Team (ECIST), NHS England and NHS Improvement.

  • Structuring a PCN Social Prescribing Service for the post COVID world
    25 February 2021

    This week we have a blog by Nick Sharples.

  • Community-Oriented Integrated Care
    18 February 2021

    The blog this week is a short extract from a paper considering an approach primary care networks could use to move towards community-oriented integrated care.

  • Strategy Unit releases opensource model for planning vaccine centre capacity
    11 February 2021

    This week's blog is from The Strategy Unit who are sharing an opensource model to help with vaccine centre capacity planning.

  • Time to talk day
    4 February 2021

    A small conversation about mental health has the power to make a big difference.

  • Supporting Staff: the emergence of ‘long-covid’
    28 January 2021

    As we are now well into a second, or is it now the third, wave of Covid-19 it is becoming apparent that Covid is something we have not experienced before and it has unique implications for staff management. It is not just the possibility that staff may become acutely ill with the virus, but that for some they may go on to develop persistent debilitating symptoms that will affect their ability to go back to work. This article looks at the implications of long-covid for HR and service managers when looking to support health care professionals (HCPs) return to work.

  • Link of the week: Clinically-Led workforce and Activity Redesign (CLEAR)
    21 January 2021

    This week we are sharing a link to the Clinically-Led workforce and Activity Redesign (CLEAR) site that is funded by Health Education England.

  • So much more than an extra pair of hands
    14 January 2021

    The introduction of the additional roles reimbursement scheme for primary care networks has started to grow capacity in general practice to address the unsustainably high workload that has put so much pressure on GPs.

  • Primary Care Networks – how did we get here?
    7 January 2021

    This week we are sharing a blog by PCC’s chairman David Colin-Thomé.

  • A year like no other
    17 December 2020

    On 5 July 1948 the NHS was born, over the last 72 years challenges and changes have been remarkable but the service has probably never been tested as much as in the last nine months. There have previously been numerous re-organisations, multiple changes to hospitals, mental health services and a shift from the family doctor towards more integrated primary care services delivered by a range of professionals. However, rapid transformation of services to embrace digital technologies, and a shift change to work differently has been forced upon all areas of the health service this year.

  • Guest blog: David Hotchin
    11 December 2020

    This week we have a guest blog that was submitted to us by David Hotchin, written by a retired friend....obviously, he's used a little poetic licence.

  • What now for commissioning?
    3 December 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

  • What White people don’t see
    26 November 2020

    This year’s Black History Month (BHM) has, unfortunately, in its shadow another example of why campaigns like this exist.

  • Primary Care: Why don’t we talk about Racism?
    20 November 2020

    Rita Symons is an ex NHS leader who is now a leadership consultant, coach and facilitator. Her work is mainly in the NHS and she is an associate for PCC offering facilitation, coaching, strategy development and team development activities. She is a concerned but hopeful world citizen and combines work in the NHS with a board role in a non for profit organisation and an interest in writing.

  • Primary Care and the Health of the Public
    12 November 2020

    By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.

Thursday, 2 November 2017

Solving doctors

It’s been a week of helpful interventions. NHS England has told sustainability and transformation partnerships (STPs) to sort out the GP recruitment crisis. NHS Improvement has taken high-impact steps to enrich the lives of junior doctors. Two different initiatives, two different sets of doctors, two national bodies determined to make the world more doctor-based and success-centric.

Magic Kingdom

We have the HSJ to thank for the story that NHS England has set STPs targets for GP recruitment. Only lack of statutory powers, resources and candidates stand in their way.

Otherwise it’s a great idea. Devolution has been focused for too long on the vulgar business of funding and not enough on finding really practical solutions to problems that Big Government is too sausage-fingered to solve.

STP unorganisations already have secondary care deficits, hospital performance and decaying social care on their plates. Added to which they have the job of plotting the route to the Magic Kingdom, the fairytale world of accountable care organisations and new care models featured in Walt Disney’s Forward View. Sorting out the primary care workforce is a breeze by comparison. 

Local GP training initiatives could obviate the need for Health Education England, local education and training boards, royal colleges and other expensive bureaucratic paraphernalia. We could even finish the job started by Lord Lansley, and get rid of the Department of Health altogether. Think of the money we’d save.


It’s no coincidence that this news comes in the same week that the department announced a consultation on relaxing medical regulation. The current rules requiring years of training and learning on the job were designed for an age where doctors were compelled to practise medicine before they were allowed to practise medicine.

But there is little to be gained by harking back to the 1950s. We need to redefine “GP” for the new world. You wouldn’t dream of training someone for ten years to flip burgers, paint your home or drive an Uber taxi, so what makes doctors so special?

GP training could open up in a variety of innovative ways. They could include opportunities for stay-at-home mums planning a return to work, retraining for eastern European plumbers and builders seeking post-Brexit job security, and courses at local colleges enabling medicine to be combined with media studies, sociology and modern dance. E-learning would allow doctors to upskill at their own pace and still leave time for evening bar work.

We don’t need stuffy old colleges and mentoring schemes. There are thousands of qualified docs on social media who trainee community doctors and wellbeing assistants could turn to for advice and support.


In other news, junior doctors responded with gratitude to a guide from NHS Improvement to making their working lives better. It turns out that traditional forms of stress-relief - alcohol, drugs, sex and contract disputes - do not work. Eight High Impact Actions to Improve the Working Environment for Junior Doctors advises, among other top tips, that they should be given access to fresh water – leading one medic to wonder if the authors were confusing junior doctors with ducks.

Animal husbandry is a recurring theme. We also learn that hospitals could employ a “dedicated pastoral lead”, who would presumably ensure that busy doctors get a break for fresh air, exercise and grazing.

Other suggestions include “promoting rest”, “rewarding excellence”, and “better engagement with the board”. The authors may be on to something here. A couple of hours in a board meeting could be just the thing to make a long shift in an understaffed emergency department suddenly seem appealing.   


Concerned that NHS Improvement may have missed some even higher impact actions, we canvased doctors. Here are some of their ideas for enhancing the working environment.

  1. Take turns to have a go on the ride-on floor cleaners
  2. Do ward rounds/surgery outside if it’s nice
  3. Customise your pager’s ring-tone or choose your own call-sign, eg Iceman, Maverick
  4. A non-smoking room with retro nicotine décor and faux ashtrays
  5. Biscuits/stickers to reward excellence and celebrate success
  6. Allotments for growing vegetables
  7. Workshops on proactive chatting, compassionate breathing and mindful positivity led by NHS Horizons
  8. Complementary sanitising hand gel.

Hospitals that adopt these innovations can expect to see an up to 1000% improvement in the morale of junior doctors, albeit from a lowish base. Don’t forget to choose a suitably high-impact way to mark each achievement along the way. The Dam Busters theme played at high volume goes down particularly well on geriatric wards. Staff in other departments will have their own ideas.

Improvement editor: Julian Patterson 


Dee Gray
Dee Gray says:
Nov 03, 2017 07:59 AM

Motivational talks from Chief Execs have been overlooked. They are really good at getting doctors to deliver on targets, especially those that make money for NHS.

Anonymous says:
Nov 03, 2017 03:23 PM

Thanks JP. Glad to see Top Gun directly referenced in this week’s dispatches.

With reference to doctors training - I think the NHS should be looking to harmonise its approach around shared life experiences. This would help reduce the natural anxiety most feel when first encountering clinical environments. I am of course referring to the happy days spent by most flipping burgers, pulling pints and de-constructing lattes.

Suggest a bell at the nurse base would help promote an overall feeling of familiarity. For example, this could dinged every time a patient is discharged with an added incentive of two dings if the patient makes it onto transport before 1000am (Refer 2017 Top 10 high impact changes affecting discharge ).

Possibly for balance we should also look at a similar approach to re-admissions? The jury would need to decide whether introducing a Two Ronnie’s sound effect from the Phantom Raspberry Blower of Old
London Town would be an effective deterrent?

b/rgs ‘Goosed’