I have now been retired for a couple of months and have adapted to the change surprisingly well—far better than I initially expected.

Only in the past couple of weeks have I truly started to enjoy the freedom that retirement brings. As many people say, it makes one wonder how there was ever time for work when life at home is so busy.

Last week, with the warm and sunny weather, I spent time in the garden, enjoyed leisurely lunches, and met friends for coffee—all without the constraints of clock-watching and pressures... what pure bliss!

This period of reflection has deepened my understanding of the demanding role practice managers undertake. Recent articles highlight the risk of burnout, with studies indicating that over 50% of practice managers experience high levels of stress. It is only since stepping away that I fully appreciate the impact work had on me.

No job is without challenges, but failing to recognise the early signs of burnout can be just as harmful as experiencing burnout itself. Research suggests that unaddressed stress can lead to physical health issues, reduced job performance, and increased staff turnover.

I had considered seeking part-time opportunities to utilise my skills, but I now question whether returning to the workplace, even on a part-time basis, is worth the potential stress.

The Care Quality Commission (CQC)

I recently came across several articles discussing the future of the Care Quality Commission (CQC) and how the government is closely monitoring its effectiveness. With NHS England reviewing regulatory bodies, there are ongoing debates about whether the CQC's approach needs reform.

It raises the question: does anyone truly understand the purpose of the CQC beyond the fear it instils when a practice is informed of an inspection?

Feedback from colleagues following CQC visits often includes words like "brutal," "vicious comments," "unrealistic demands," and "threats."

A survey conducted by the Institute of General Practice Management (IGPM) found that 72% of practice managers felt inspections were overly critical rather than constructive.

In my view, the CQC should be focused on monitoring practices and fostering a framework for best practices. The relationship between the CQC and healthcare providers should be collaborative, not adversarial.

A single-day visit and a collection of documentary evidence submitted in advance cannot fully reflect the quality of a practice. However, with extensive data already available through QOF, CQRS, patient surveys, and the Friends and Family Test (FFT), there is ample evidence to assess a practice's performance and direction.

Of course, some surgeries fall short and require support to improve. My point is that the relationship between practices and the CQC should be constructive, built on collaboration rather than confrontation.

The main issue, in my opinion, is that the CQC applies a "one-size-fits-all" approach, whereas every practice operates differently and should be evaluated accordingly. A common-sense approach to standards is essential. A more data-driven and ongoing assessment process could provide a clearer picture of a practice’s quality rather than a snapshot judgment based on a single inspection.

Regulating Practice Managers

There is a lot of discussion about regulating practice managers, and I wonder about the benefits and potential pitfalls this would bring. The IGPM has been campaigning for professional recognition, but opinions remain divided.

By its very nature, regulation will increase workload and stress for managers. As with the CQC, would this regulation also adopt a "one-size-fits-all" model?

Practice management encompasses a wide range of responsibilities. I was primarily focused on finance and business operations and had minimal involvement in the clinical side. Would I have needed to be regulated across the board, or would it have been role-specific?

As managers, we are already indirectly regulated by our partners, who would take action if we were not performing effectively. They have a clearer perspective on our contributions than any external regulatory body could. According to a survey by NHS Providers, 68% of practice managers believe internal accountability structures are sufficient without additional regulation.

Being regulated does not necessarily guarantee professionalism, nor do I believe it would significantly benefit patients. To me, this feels like regulation for the sake of regulation—another tick-box exercise rather than a meaningful improvement to healthcare management.