09 Feb Quick chat with… Georgina Craig
Work/life balance – is it possible or is it a myth?
Running your own business is very different to being an employee.
Achieving work-life balance sometimes feels like a pipe dream when you are self-employed – especially if you are passionate about making a difference to peoples’ lives and your work is all-consuming.
I have been close to the edge, run down and burnt out by my work in the past. I have learned a huge amount over the last few years about myself, and what works for me so I have completely changed my approach.
Nowadays, I focus mainly on the impact of my work, rather than seeking to do everything that lands on my desk. Out of necessity, I have become very focused on outcomes.
I worry much less about how I achieve change. There are no sacred cows anymore. I will try anything once.
My primary outcome is, how can we spread group consultations as widely as possible? And I am working in a variety of ways to achieve it. This focus means that I am most interested in supporting NHS organisations to embed and build an in-house capability to support that – even if that means my social business makes itself redundant in the process. I am also very interested in joint ventures and partnerships that support this mission, and in time, I see these partnerships becoming an important way of achieving my outcome.
Working this way has meant I have been able to reduce costs and focus more on improving quality. This, in turn, has reduced my stress levels so that my work life balance is completely transformed. I am much happy and healthier for it, and I believe the business is having a greater impact too – so it has been a win-win.
What’s the most useful thing you have learned from working with primary care teams?
My biggest learning is that – what the NHS measures drives GP behaviour – and the way we measure impact is the root cause of most of the inefficiencies in the NHS.
That is why I spend a lot of my time persuading system leaders to focus on outcomes rather than outputs and process measures; something which almost never happens right now – even where an ‘outcomes based’ approach is purportedly in place.
When I talk to GPs and practice nurses, they often express their frustration too.
I believe that if frontline teams were trusted to support people to keep well and improve their lives (health creating outcomes) and that was everyone’s focus, between them, frontline teams and families would sort out the detail; people would keep well and staff would feel empowered and love their jobs. That is essentially the Buurtzoog model of community nursing.
Instead, because of the way they measure and reward providers, NHS system leaders over-specify everything; focus teams on inputs and outputs as the main currency, and create artificial barriers that lead to unhelpful, tribal behaviour.
It drives me mad, and I hope that I can help offer some new thinking around measuring progress towards the outcomes that really matter most. That’s my big passion!
What is the biggest challenge GPs, and general practice, are currently facing?
The biggest challenge primary care faces? Letting go of the belief that the medical model can solve the public health challenges we face.
As people live longer, and their health and mobility starts to fail, it is social isolation and a lack of purpose in their lives that drags them down first.
No amount of medical intervention will turn that around. If we want to keep people well and improve their lives, primary care teams need to be community builders not ‘social prescribers’.
Ironically, the way forward might be going back to the future. In the days when clinicians had little in the way of clinical therapy to offer patients, they had no alternative but to practice social medicine. Maybe we inadvertently threw the baby out with the bath water back then? This is what Atul Gawande calls “the problem of hubris”, and to me, it makes perfect sense.
Where do you see the future of general practice?
General practice will always be the foundation of the NHS. That is not up for debate, and it never will be. General practice must believe this is true; step up to the mark and ask itself, given that we are no longer here to cure people (because most of our patients live with life-long conditions), how can we become the best as we can be at supporting people to keep well and live life to the full? General practice needs to ponder the best way that it can contribute to that human-centred outcome.
What good looks like will be different in every practice and the future needs to be decided by communities – including primary care and teams and others who will be contributing alongside them – most importantly, of course, people and their support circles.
What would you say about general practice to medical students and young doctors who are thinking about their career options?
What difference do you want to make through the work you do?
General practice transforms peoples’ and communities’ lives.
If that is your bag, sign here!
Georgina Craig has over 25 years’ experience working with primary care teams to support innovation and practice improvement. Currently, she is supporting clinical teams to transform outcomes for staff and patients by applying the group consultation approach (www.elcworks.co.uk).