The Wednesday pulse: you are not the spare capacity

There’s a familiar temptation in this week’s correspondence.

Patients are waiting. A colleague is overloaded. Recruitment needs attention. There’s an unused session in the diary, but somebody needs to sort out the equipment, staffing or bookings before it can earn its keep.

The owner looks at all this and thinks, “Perhaps I should work another half-day.”

I understand the temptation. But before you give the business another piece of your life, ask what that extra session would actually solve.

Is it sensible, temporary cover? Or will it simply allow a problem to carry on because you’ve stepped in again?

One owner this week was resisting the temptation to give up an afternoon with the children. My advice was to protect that afternoon while we worked through the alternatives.

Sometimes extra cover is necessary. But make it a deliberate decision, with an end in sight. Otherwise, every gap becomes your responsibility.

You are not the practice’s permanent spare capacity.

The diary conversations have been revealing. Waiting lists alongside missed appointments and unused sessions. A room that exists but isn’t suitable for the work required. A new clinician who is available, but without the support or patient flow to make a useful start.

“Busy” tells us very little.

Where are patients waiting? Where are we losing time? What is stopping the team we already have from delivering the appropriate care?

The answer might be investment in equipment that removes a genuine restriction. It might be recruitment. Or it might be the less glamorous work of confirming appointments, recovering cancellations, planning the diary and making sure somebody at reception owns the process.

Identify the constraint before you spend money on the solution.

There’s a similar point in the conversations about people.

This week, some owners have described colleagues who appear disengaged. Others are concerned about dependable people carrying too much.

Those require different responses. Telling everybody to “step up” won’t get us very far.

Be specific about what needs to change. Has the person been shown the standard you expect? Have they got the time, confidence and support to meet it?

And for the colleague who quietly absorbs everything, ask what you can take off their desk.

Patients need to stay in the picture too. One check-in raised a concern about whether the expected treatment result had been explained clearly enough.

That needs attention before the next conversation about expansion. We need to understand what the patient believes they have been promised.

There has also been enthusiasm for new software. Fair enough, but look beyond the demonstration.

Ask about migration, training and support. Find out what disruption the team will have to absorb, alongside everything else you are already changing.

You can like the product and still decide that now isn’t the time.

What encourages me is that owners are raising these questions before making every decision. They are noticing the pressure on their people, questioning the numbers and recognising that their own working week cannot keep expanding.

That’s part of the value of community. You can put a problem in front of people who understand the responsibility, without feeling that you ought to have the answer already.

This week, choose one recurring problem that keeps landing back with you.

Give it a named owner. Agree the support they need and a date to review progress. Then check whether your involvement is actually reducing.

Some things need a decision. Some need a proper handover. Some can wait. You don’t need to turn all of them into another project.

And before you offer another half-day, work through the alternatives.

Keeping the afternoon you promised your family may be the most sensible business decision you make.