Scrutiny

2012 has been quite a year. A year of personal scrutiny. What does that mean? The word apparently originates in Latin: scrutinium; from scrutari, meaning "those who search through piles of rubbish in the hope of finding something of value." A common definition is: 'to look closely (as for mistakes)'. Seems apt.

The start of the year (and the 2 years before that) saw our practice achieve the RCGP Quality Practice Award, a real team achievement and recognition of the focus on patient service, access and meaningful systems by the practice and its attached staff. The visit, following an enormous submission of 'evidence' included patient and staff interviews, observation and a nurse going through every drawer in my room to make sure all was in order and in date. That was a nervous ten minutes. We passed, and it has been a great experience for staff morale and a catalyst for patient engagement in the practice.

As a CCG Chair I then had an assessment to ensure I was able to fulfil the role, at least on paper. Maths and English tests and 360degree leadership surveys were followed by a visit to London where I was interviewed in great detail by the Hay Group and underwent a series of role play and written assessments. A full day later I had a stamp of approval and my first ever migraine. I also discovered that after a certain age writing for 30 mins in examination conditions is almost impossible. If the writer's block doesn't get you, the cramp will.

Next came authorisation. Armed with personal approval to be Chair, was the CCG up to it? We promised ourselves we'd take it as part of the day job, that we were doing the role, that we wouldn't get submerged in 'evidence.' We were wrong. To anyone who thought the process would simply be a formality, the fact that only 8 CCGs have been authorised without conditions (including Bassetlaw) will hopefully provide some assurance. We are a better CCG for having been through the process, but it's good to be focusing on quality and patients rather than process.

Finally, revalidation. My appraisal today was very similar to previous appraisals - a valuable opportunity to reflect on my clinical practice rather than policies and process. So what was different about a 'revalidation appraisal.' Mainly the surveys. Another 360 degree survey, but this time my colleagues in the practice, both clinical and managerial, including my secretary and other reception staff. This was followed by a patient survey. Both were done through an independent company (Edgecumbe) and the process was very smooth with clear reports afterwards. It felt much more personal than previous QOF surveys, and unlike previous 'leadership' surveys this was about my interactions with patients, my consultation skills, how I support staff.

So all my evidence has been submitted now for revalidation. The CCG has been authorised. The practice has the QPA for the next 3 years. A good year, with a focus on quality and assurance. 2013 should be easier. Wait, what's this on everyone's twitter feed? 35 outcomes for CCGs? A new planning framework? More scrutiny by the Local authority?

Better start collecting evidence.