Last month, Kay Keane, became the first practice manager to be appointed as a non-executive director to the National Association of Primary Care (NAPC) board. 

Ms Keane has been a council member for the organisation, which represents the interests of primary care professionals, since 2017, when she won the NAPC Practice Manager of the Year Award.

She started her journey in the NHS as a receptionist at the age of 20, and has since worked for clinical commissioning groups (CCGs) and health authorities, before becoming a practice manager in 2015. 

Ms Keane spoke to Management in Practice about what inspired her to become a leader, the vision and aspirations she has for the future of general practice and why it is important for practice managers to be heard. 

What inspired you to join the NAPC board, and what are you hoping to help achieve in this role? 

I have been on the NAPC council since 2017, and it has given me the opportunity to understand the amazing work the organisation does. The NAPC represents the interests of primary care professionals, and is at the centre of shaping the future of healthcare, spreading innovation, influencing policy, and supporting and connecting professionals across primary care.

As an organisation, it is always looking forward – focusing on ensuring that what we do makes a difference and improves primary healthcare, the local communities and the patients we serve – and this has always been my goal too. 

In my new role, I want to ensure that the non-clinicians are represented at the highest level. Anyone who has heard me speak before will know that I think practice managers and all the administrative support staff in primary care are superheroes – we need a voice at the table and I am honoured to be that voice. Great teams make great healthcare – the PM role is as vital as any other player in that team.

What does it mean to be the first practice manager on the board?

It is a little overwhelming to be honest. I just need to ensure that I do justice to the profession and try to ensure that our voice is heard and considered. I am so proud to be a practice manager – we are often the glue that sticks the teams together in general practice, and many organisations forget that. I am grateful that the NAPC has understood and recognised our importance. 

What sort of change would you like to see, across the board, to help general practice survive and thrive, particularly in light of the Covid-19 pandemic?

I would like us to feel trusted. We, as practice managers, run successful businesses, employ staff, ensure we are financially viable, deal with complaints and compliments, and manage patients, stock and safety, but for all those things there is a form, return or a monitoring exercise to do. I would love to see that we were trusted and supported, not questioned and monitored. 

I understand that there will be exceptions, but as a profession, we need to feel that we don’t have to justify our being. I’ve worked in the NHS for over 25 years and it was a problem in the past and still a problem now. We need to let practices and managers thrive and develop in their community and react to the local need – not just what is expected. Some of those constraints have been removed during Covid, and I for one hope this is the legacy of this awful time.

How important is it for practice managers to have representation at national or local level? 

Practice managers really are the key to a successful general practice, as we are the ones that make sure things work so that patients have the services they need. We have been, and continue to be, underrepresented as a profession. Thankfully, the NAPC works with the Practice Managers Network, which is a great organisation offering support and guidance to practice managers – but I think we can do more.

The fact that the NHS new to partnership scheme didn’t support practice managers as partners felt like a kick in the teeth for us all. I want us to have a voice and to ensure that we are considered and regarded with the importance that we deserve. I am delighted to be the person at the table to keep saying ‘don’t forget us’ and ‘we are already doing that’ or as it feels at the moment ‘we can’t take anymore!’

I am active on social media and have never known a time when I have seen so many of my trusted colleagues tell me that they have decided to leave, and that the expectations and demands from the wider NHS are just too much. 

I think in years gone by we were not considered a profession, we were seen as receptionists who got promoted or the GP’s secretary who took on some more management duties. Now, thanks to the NAPC, we have a recognised leadership qualification, which has been developed along with Capsticks and the Healthcare Financial Management Association (HFMA).

This will equip managers for the next stage of their careers and solidify existing learning. I have completed the qualification myself, and although it’s hard work, it’s so very worthwhile – not just because of the learning but also for the contacts you will make. I met people I would never have come across before and I know they will be part of my network for years to come.

What do you see as the key challenges for practice managers at the moment?

Wellbeing is a key issue for us – so many practice managers are struggling. As the chief plate spinners in GP practices, we are keeping everything and everyone going, and sometimes we forget our own health. The NAPC is all about continuous improvement and rising to whatever challenge comes along, and we need to remember that for our own wellbeing too. 

I would say that we need to fix our own balance first – the saying ‘you can’t pour from an empty cup’ is very true. I walk to and from work (and collect rubbish on the way with my litter picking stick) and this gives me time to sort out my internal filing system. Then when I get home, I can usually forget about work. I also have an allotment and enjoy growing flowers, which helps my mental health massively. Planting a seed is to have hope. We all need that at the moment! 

What are you looking forward to most in this position?

I am most looking forward to representing the place and people I love and believe in – all the administrative staff that keep primary care going. I want to give a voice to the volunteers that we have working with us, they give their time and vast skills to make us more resilient. Of course on a personal level, it is amazing for me to be on the board of a national organisation, and it’s something that I never imagined would happen, so I am also looking forward to my own development opportunities. There is an incredible array of skills on the board and council, and I know I will be able to learn so much from all of them too.