Meeting the increasing needs of an ageing population with limited resources is a challenge most practice managers are facing at present, reflected by frequent media reports of primary care staff shortages nationwide.
Management in Practice’s reporter Valeria Fiore asked Devon-based practice manager, federation manager and occasional CQC inspector Tracy Green how she overcomes this obstacle and keeps her practice thriving.
Q: What is the biggest challenge you are facing as a practice manager?
A: The increasing patient demands and expectations versus the reduction of clinical staff such as GPs and nurse practitioners and the tight financial envelope that we are given.
Q: What solutions have you implemented to address this challenge?
A: We have changed the model of care, done analysis about what type of consultations GPs were [giving] and expanded our duty team.
I also changed the way appointments were offered. Now, a third of appointments are 28 days pre-bookable, a third of them are three days pre-bookable and a third of the sessions are available on the day. We like to think that we never turn a patient away.
We have also increased the amount of telephone appointments and converted two 10-minute face-to-face appointments into four five-minute phone calls, as more patients are using those.
On each session, we include a GP pre-bookable slot because we know GPs need to book patients in some months in advance. This slot is protected for GPs, which helps with the continuity of care.
Q: How is your experience as a CQC advisor helping you as a practice manager?
A: I started as a CQC advisor in October 2014 and I have inspected over 50 practices. This experience has supported me in making sure I can deliver safe practice because it allows me to thoroughly understand what the CQC are looking for.
It gave me credibility with my team because they know that I have done that in other practices. So if I were on inspection team in my own practice, I would tell them what I want them to change to become outstanding.
Q: What projects do you have for the future?
A: We are looking into implementing a training hub, where clinical and non-clinical team can benefit from training across the seven practices rather than having each of us doing our own training.
Q: Which are your biggest achievements as a practice manager?
A: The culture of the practice has changed enormously. People take ownership for what they do, it is a very inclusive and collaborative environment and communication has increased dramatically. We have regular meetings, including one-to-one. The nursing team have coffee together every morning and afternoon.
In January, I launched Cricketfield Academy to break down the administration tasks into three different levels. Whenever someone starts new in the business, they are on level one. As they improve, they can move to the next level. The purpose of the academy is to encourage the staff personal development and to nurture their aspirations.
Q: What does it take to be a good leader?
A: Resilience, flexibility and a dose of humility. You need to be able to know your boundaries and when you need to ask for help as well. You need to be organised, proactive but also have humour and very good communication.
Q: What are you reading at the moment?
A: I am reading a book called ‘Drive’ by Daniel Pink. It is about what motivates different people, so that is really inspiring.
I have just got my holiday book, which is called ‘Shine’, by Andy Cope and Gavin Oates. I read one of their other books before, ‘The Art of Being Brilliant’. It is about remembering that every day is a new day and we only live about 4000 weeks in our lifetime. So let’s not waste weeks because someone might have upset us! That is my motto at the moment: trying to be my brilliant best.
Tracy Green is a business practice manager at Cricketfield Surgery, Devon. She was rated number 7 on the MiP list, Management in Practice’s list of 25 outstanding practice managers.
