Does you does or does you don't...*

So we hover on the threshold of a brave new world, of which doubtless much more later—unless of course that nice Mr Lansley ponies up my share of the £70Bn all in one go, in which case I might soon be blogging from the Cayman’s. Somehow I think not though so you might all be putting up with me for a bit yet.

One thing we’ll not be missing from the old regime is the ceaseless buggering about with targets they like to call “micro management”. One of the weirdest of these was something they liked to call “Access” where the Holy Grail was that punters in need could get to see a doc within 48 hours. This was for us a nonsense, since punters that need to see a doc get fitted into a duty surgery appointment same day. Bit of an un-missable target then, or so one would like to think. Still we spent a happy year or three making monthly submissions to the PCT to prove that this was what we were doing, boxes duly got ticked and we all carried on our merry ways rejoicing.

Or so I thought until last week. For last week in walked a very shaky Susan. She’d not been to see us in over a year, so I was a bit surprised when she said she had come for a repeat of her anti-depressants, also not issued in over a year. I gently inquired as to the reason for the gap in treatment. It transpired that Susan had been seeing Dr Neighbour regularly for her combined anxiety and depression symptoms up until a year ago. Then the Cllr Dan Archer Memorial Car Park and Pizza Franchise just over the road from the surgery was closed “for maintenance”. This meant Susan having to park on the far side of town and walk through. Given the agoraphobia that was a large part of her presentation, this proved physically impossible for her, so she just stopped coming, and waited, indoors, for a year, for the CDAMCP&PF to reopen, so she could start attending again.

Of course no amount of measuring “access targets” can spot a patient like Susan falling through the cracks. I’m not sure anything else in our current armamentarium will either. You see we’re very good at pulling up people we think are over-using their meds, but we tend to the view that punters who stop filling scripts and coming to see us are either better or have moved on to other avenues for help. In common parlance it’s “a bit of a bugger”, and it rather puts all that silly target nonsense in the shade. Access indeed.

* I know it's unfair to readers in other juristictions, but an EVCHN to the Blighty based reader who can spot both the inane reference, and the sublime progenitor (the original song that is) for today's title.