This pandemic has not been just one big challenge, but rather a whole series of different challenges over an extended period of time.  As we move into yet another phase, and the next set of challenges, where does the energy come from to keep going?

At first there was the arrival of the pandemic itself, changing the operating model and moving to remote working, and putting systems and processes in place for managing patients presenting with Covid symptoms.  Then we had to work out how to do this alongside the normal work of general practice.  Then we had to introduce a vaccination programme, which has been all consuming and itself a series of different challenges (different vaccine types, care homes, housebound, practice dispersal etc etc).

One year in, we are once again moving into a new phase and a new set of challenges.  Some of the core services (such as QOF) that were put on hold are restarting.  The vaccination programme continues.  The work of PCNs accelerates, as the ARRS nearly doubles in size and the move towards integrated care means PCNs have to start to play an important role in influencing the system as whole.

But are we ready for more challenge?  How do we find the energy and personal resources to cope with and manage more change, more disruption, and yet more new ways of working?

We have not been good in the NHS at looking after the people who work in the service, or indeed at looking after ourselves.  We have known for a number of years that most GPs are looking to reduce the number of hours they work, and a large percentage of those who can are planning to retire in the next five years.  It is not just GPs; many practice managers and other members of the practice team are also looking to leave.  The recent pay offer for NHS staff and the freeze on the lifetime pension allowance is not going to help.

The continual wave after wave of challenges the pandemic is creating has made this situation more critical than ever.  If we do not take time now to look after ourselves, and look after the people we work with, it wont be long before the exodus of people out of general practice reaches unprecedented levels.

We have to prioritise our staff and ourselves.  The good news is that there are actions that we can take.  In this week’s podcast I talked to resilience expert and GP Dr Rachel Morris.  She outlined a range of tools, techniques and approaches that can all help with personal and team resilience.

It seems to me that the starting point is deciding that looking after ourselves and our teams is the priority.  We cannot rely on or even expect other people, or the wider NHS, to do that for us.  Most people working in general practice have spent a lot of time doing whatever has been needed to meet the different Covid challenges.  Going forward the only way general practice is going to be in a position to serve its local populations is by ensuring it takes time now to invest in itself and the people who work there.