A Covenant and not a Contract

It has been an intense winter and in the three-way tussle between doing the day job, staying healthy and blogging it was always the writing that would have to give. It’s good to be back, though, and with renewed energy – although how long that lasts may well depend on which Government is elected on May 7th, and what they decide to throw at General Practice over the next five years.

It’s good to start afresh with a positive blog – one, oddly enough, inspired by the Care Quality Commission (CQC). I’m not the greatest fan of inspections, nor have I been impressed by the approach taken by the CQC as it has moved into doctors’ surgeries, but there are times when doing something you don’t want to do bears unexpected fruit.

One of the requirements of the CQC is that GP practices should have a ‘Vision and Values Statement’ that all staff should be familiar with. Knowing that we could be quizzed on such a statement at any time during an inspection, and that it would be hard to give the right answers if we didn’t actually have one, we set about to rectify the situation.

I confess to having an attitude more becoming of a teenager told to tidy their bedroom; just as an adolescent is convinced that they know where everything is in their own private world and so what is the point of tidying just to please Mum and Dad, so I knew that we understood our values and wondered what good could possibly come of writing them down just to tick a box.

It all felt very corporate. We looked for examples from others so that we would not have to reinvent the wheel, but they left us feeling flat and uninspired – they were other people’s values and not ours so they just didn’t resonate. It turns out, that when it comes to what really matters to you it’s best to invent your own wheel after all.

Then I remembered a line I’d heard about General Practice that had excited me and it was this: that the relationship between a GP and their patient should be a Covenant and not a Contract.

From that beginning, it suddenly became easy – and I am converted: writing down your values is worthwhile after all; it really did help to be able to look at them together as a practice and say ‘yes, this is what gets us up in the morning’; it’s helpful to remember them on a bad day when you’re tired and you’ve lost sight of what you believe in; it’s good to know that they are there as a yardstick for us to measure ourselves by – and one that we have put there on our own account rather than something that has been imposed upon us.

It feels scary to do so, but we would like our patients to know our values, and would like to know what they think of them. They are ideals – some would say idealistic – and we know we won’t always live up to them. What will happen when we fail? How will we feel if a patient throws them back in our face and tells us how badly we have let them down and how hypocritical we must be? It’s a risk we will have to take, but it feels a risk worth taking. More likely is that our patients will help us to shape these values further and improve them.

So, we have published them on our website, and we’d be interested in your thoughts.