⏳ Leadership Time — But Only After Resignation
After a year of firefighting, I’ve been handed the matchbox. Two months left. Let’s see what we can ignite.
I’ve finally been given protected leadership time — ironically, just weeks after submitting my resignation. This reflects a larger problem in our system: reactive leadership, not proactive.
Simon asked me if I might stay now – too little, too late. One of the key bosses has not met me in the 13 months I’ve worked for her – where is the teamwork? It’s been tough to work at the whim of those who lack capacity to self-develop or reflect – never again. But still, I’m looking forward to making some improvements in the remaining two months I have left here – not least, rebuilding a sense of teamwork and community. The meetings will be with Jamie, our excellent practice manager.
🧩 The Erosion of Community
Today we talk about how the erosion of community in modern life is leading to deprivation of a human need for meaningful connection and purpose. Without it, people lose happiness, fulfilment and health. This is no small issue. And we must nurture it in our working environment and consider how we can create community in our patient population.
✅ First Change — Prioritise Meetings and Management Time
First change — prioritise staff meetings and management time over delivery of service. Even if it means we have longer waits for patients to get the service they need. Short-term pain for long-term gain. Get the fortress in order.
We will now have 5-minute morning huddles to enable staff connection, teamwork and communication of daily issues. All good GP surgeries have morning huddles and regular meetings. Our regular meetings are cancelled frequently. So we’ve agreed that all meetings must go ahead irrespective of staff absence, there needs to be someone deputising and the meetings need to be fully attended.
🩺 Quality Improvement: Painkillers and the Role of the Pharmacist
Next — the regulator (CQC) inspection fed back on the lack of quality improvement projects and audits we have here. We have an excellent pharmacist, Simon, who will now develop a project on reducing the amount of painkiller prescriptions we issue (long-term addiction and tolerance are a real problem, so this needs constant policing as it really damages the population without proper oversight). The prime example of this is the American opioid (e.g. morphine, fentanyl, oxycodone) crisis which has resulted in drug misuse, addiction and death — affecting mostly young to middle-aged adults.
🧠 Assessing Leadership and Time Use: The Case of Helen
Next – we’re assessing Helen, the advanced nurse practitioner’s use of time. The clinics she is booking herself have so many wasted slots. This is usually a sign of someone overwhelmed. Furthermore, she has leadership time that needs transparency and structure. We need to support playing to her strengths to get her going, as she can be utilised better for all parties.
She’s also facing a complaint and isn’t engaging with any other people higher up in the organisation. Jamie was told, “I don’t have time to talk about this,” when he brought it up. It’s a real issue — she will be in breach of contract if she doesn’t follow the complaints process. I have a supervision meeting with her later, so will ask her to play ball. Everyone is walking on eggshells with her. But we do need to call a spade a spade.
🛠️ Finally, Space to Lead
It feels so good to finally step out of the weeds and into the architect’s chair — to strategise, make changes, and implement ideas. You can’t build a fortress while patching leaks with teabags and hope it holds.
Our system must once again place doctors with a vision for leadership at the helm of shaping it. There is no doubt about it.
Mindful Medic 