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Feeling the Pain of the Practice Manager

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Within its KLOEs, the CQC includes leadership. Wherever you work, an integral part of leadership is team and organisational management, and within the GP practice much of this rests upon the shoulders of the practice manager. In a recent report, the King’s Fund has concluded that practice managers need more support. We couldn’t agree more.

Standing up for the practice manager

For many months, discussions surrounding primary health care have concentrated on the effects of higher numbers of patients, difficulty to recruit new GPs and financial constraints. All of these issues are explored in the King’s Fund report titled Understanding pressures in general practice, with the conclusion that “General practice is in crisis”. The report also concludes that practice managers are “isolated and unsupported”.

Apart from the need to oversee an ever-expanding patient population; practice managers also have responsibility for increased requests for paperwork – often generated externally from hospitals, solicitors and employers for example.­ This is time consuming work, taking the practice manager away from higher-level strategic duties.

There are strategies and methods that the practice manager can employ to make time in general practice, and these should become habitual practices. Even so, the greater integration of healthcare, well being and community services in a holistic community approach places extra strain on the practice manager.


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Increased demand with inadequate funding

When we discussed the future of the practice manager this time last year, we wrote about the importance of funding the new model of care. If the GP practice is to be at the heart of the new way of providing care, then funding must be made available to enable this to happen.

That funding was promised in return for general practice absorbing demand: a lagging payment if you like, and not one that helps the practice manager prepare the practice for increased demand upon its services. You might remember that we wrote:

“Providing GP practices are willing to accept the new formula and new methods of working, practice managers will be able to evolve their practice’s service and increase their funding to do so.”

That funding appears to be both woefully inadequate and reactionary.

Practice managers are left fighting fires with poor resources, lack of staff and underfunded to do so.

The King’s Fund’s answer

In its conclusion, the King’s Fund’s report says there must be radical change, leading to innovative models of general practice. These might include multi-speciality community providers, with greater collaboration over patient care.

Unfortunately, this approach might put further stress on the practice manager. Perhaps more convincingly, the report argues that, “If general practice is to remain at the heart of the NHS, it must have an adequate and stable funding stream for core services.” It also makes the point that adequate staffing levels are essential, “otherwise, it will run the risk of spreading an already stretched workforce across longer working hours, thus increasing the workforce challenges.”

The King’s Fund, it seems, may be starting to realise the pain that practice managers feel every day of every week.

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