My working life

Beginning

I started my career training as a nurse at the Middlesex Hospital, left to get married, but didn’t make it to the altar, so had to find something else to do

I have had a few brief spells doing other things such as booking mountaineering holidays, but basically stayed in the NHS. I worked at the National Heart Hospital in records administration when the first English heart transplant was done there.

After a second, more successful, attempt to get to the altar, I raised four children and needing to refocus after 11 years, re-trained as a medical secretary, working for an eccentric consultant chest physician in the West Midlands.

On the move
My husband’s job took us back South to Watford in 1989, where I was taken on as secretary/bursar to a primary school in a very deprived area. Here I encountered my first real computer, sitting on the desk with a tea towel over it because no one knew how to work it. A few day courses later, I was proficient in running the accounts, the pupil database, and the word processor, to my relief.

There was just something about feeding in data and playing around with it that I found really satisfying, and worth exploring further.

This gave me courage to apply for my next job, deputy practice manager at a large GP surgery on the outskirts of St Albans. As the partners were young, not unattractive, enthusiastic GPs, I was happy to accept! I had sole responsibility for the accounts, the computer system, server and networks, transcribing all the letters and any other medical secretarial duties that came to light, plus deputising for the practice manager, who only worked four days a week. Needless to say the most aggressive or difficult patients always chose that day to cause trouble….

On my first day, I discovered that this was also the day the practice was moving into a newly built large extension, and the first day on their new computer system, turning to EMIS from AMC Meditel. No-one in the practice had got to grips with the computer, they were far more interested in their wonderful new consulting and waiting rooms. It did not take me long to discover that not one item of prescribing data on 14,000 patients had come across! Nothing for it but to gulp and start to put it all back in, keystroke by keystroke, with some help from the nursing staff.

MSc in the new subject of ‘Health Informatics’

It was obviously unacceptable that no-one understood how to get to grips with the new system, so I pleaded to be sent on a health informatics certificate course. No one had heard of the term, but they saw the value in a bit of expertise, so I was allowed to enrol with the University of Southampton on a one year course. Having completed that, the university suggested I progress to the postgraduate diploma. A raised eyebrow or two, but the funding emerged, and I continued distance learning, and went off to three day workshops in Southampton, learning not to mind being away from home in strange lodgings on my own.

By this time the PCT had got to hear of my strange interest, and asked me to do some part time work for them. This didn’t go down too well with the surgery, so I did it in my own time, working late hours to make up for any time off to go to meetings.

I must have been mad, but around this time the Practice wanted to increase their income by becoming a training practice for GPs. This involved having all the notes summarised. Despite pleas, threats, and cajoling, the GPs didn’t fancy spending their spare time pouring over notes, so I took this on too. I took baskets of notes home every night, and in 18 months had summarised 12,000 records. When the training accreditation was finally given, it was the PM who got the bunch of flowers, that’s life! (Actually they should have gone to my husband for putting up with a wife who was so often preoccupied with something other than the vital activities of cooking, clearing up, and helping raise our four children).

From GP Practice Management to PCT IT

When a practice manager post became vacant in the centre of St Albans, I moved there. By now my diploma was on its way to becoming an MSc in Health Informatics, and soon after I moved full time to the PCT.

I graduated, but the PCT hit financial difficulties, and I applied and was awarded the post of Primary Care Liaison Manager at West Herts Hospitals Trust (my first real Powerpoint presentation!). However it seemed they were actually scared of the idea of any real primary care liaison, and as I was not allowed to visit the practices, I had to content myself with building them a website. It was here I learnt how to handle consultants. Emails for information were totally ignored, but tell them you were going to post your own ideas of their service unless they amended them by a set date, and suddenly the invitations to visit operating theatres came popping in!

The local PCTs merged, became more financially viable, and I was recruited back to sell PRIMIS data quality training to all the practices. I was in my element, it was a huge amount of fun, and I learnt how to spot and turn the most reluctant GP into seeing the benefits for his practice.

From there I was promoted to IM&T Management. I believed in an old fashioned form of management, ie that a manager is there to supply everything that their employees need to function efficiently , be that physically or mentally.

I set up a Managed IT Support service for practices, with each engineer having an allocated group of practices they visited regularly, almost becoming part of the staff. They knew the quirks of their systems and could most often right a fault over the phone. We asked practices what they needed to be replaced, and kept spares for emergency swap outs at the PCT. The practices loved it!

Ealiest form of GP2GP created

I also introduced data transfer on CDs to save the reams of paper printed out when patients moved practice. This introduced me to the clinical directors of the main clinical computing companies, holding a rare (for them!) summit meeting at the PCT and getting them to join me for lunch in a local pub afterwards. It was also around this time I came across the Primary Health Care Specialist Group, never dreaming I would one day be coerced to become its Chair!

Enough is Enough
The NHS is a vast, very strange beast, and it takes years to understand it. You have probably just started to get a handle on it when the next reorganisation comes along. Sadly these huge disruptions have dreadful effects on staff morale, and I believe often patients suffer too. By 2008 I had had enough, and an email call ‘anyone want me’ produced an invitation within the hour to work for EMIS, which I did for 18 months, before they ran out of work for me. I decided to take the plunge and go independent, enrolling with agencies, then creating my own company. My first contract was working for NHS London rolling out sexual health services in conjunction with the Terrence Higgins Trust. Arranging sites in parks for condom drops might be some people’s cup of tea, but I was relieved when that one came to an end, and an East London PCT picked me up to work with their most poorly performing practices. That was more like it! I met some lovely people who were really struggling, and it was wonderful to show them how a few small changes could make such a difference. That went down so well I was asked to stay on, for three years in fact. I managed to put in QUTE and implement EMIS Web for all of them,
So that’s me!
Volunteering demands have crept up, and the parents of our seven grandchildren need a certain amount of help, which is why three days a week is the maximum I can consider now.