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The key to effective practice management

21 February 2017

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Dwysan Rowena advises on how a practice manager can juggle their various roles while propping up a busy practice

What is a practice manager? Simple. A manager of a practice. But what does it actually mean? The responsibilities vary, particularly with the size of the practice. A large practice could have 10 managers; a smaller or medium-sized practice often has only one.

The manager of a practice usually has overall responsibility for the organisation’s administration such as clinical governance, health & safety, personnel, payroll and budgeting. However the role also often becomes almost parental – the practice manager can become the confidante, counsellor, gutter cleaner, toilet unblocker, referee and peace-keeper. In a nutshell, a practice manager will never walk into work knowing what to expect. Ever.

Main challenges

Like managers in any organisation, a practice manager has many standard challenges such as small budgets, set targets, employee disputes, recruitment, planning, business continuity and technology problems. Along with this, practice managers have another enormous pressure – from patients. There is a huge pressure to provide a high-quality, safe, expert service in a situation where demand almost every day outweighs available resources.

Along with this, many practices can’t staff their surgery with a full complement of clinical staff because of the shortages in GP recruitment. A practice manager needs to juggle their roles and be an effective leader too, but how can they do this? Here are 10 tips to help.

1. Communicate

Communicating properly is the main solution to effective management. It may sound an aged theory, but without successful interaction between managers and the rest of the team there can be no triumph. 

The best managers communicate through a number of ways. Sending out 100 emails every hour won’t win any manager much respect. It’s also unrealistic to think there’s time for sufficient face-to-face contact or regular team meetings. Picking up the phone occasionally instead of sending an email can make the world of difference to a colleague. Spending one-to-one time even for a few minutes a day can strengthen relationships and encourage trust and respect.

An effective manager may not be able to know the ins and outs of all of their team but spending time to take an interest in the workforce can be rewarding for both the manager and staff.

2. Be a team

Make decisions wherever possible as a team, even big ones. Whether this involves recruitment, budget cuts or even a new kettle, wherever possible consult with the team. It’s not always possible to discuss every little thing but when it’s likely to matter and to have an effect, make sure the whole practice has a voice. 

Regular team meetings are important. Hearing the voices of receptionists, healthcare workers and nurses is vital to the creation of a happy team. There are major advantages to involving the team, not least that the responsibility is shared. There won’t be any more glaring looks at the ‘management’.

Also, various team members have different perspectives on solutions. A receptionist is one of the most powerful members of a practice, the first point of contact for patients. Their right to be heard is essential, along with the rest of the employees who may all have vital input into the shape of the organisation.

3. Be professional

It’s a sad but an important fact that managers can’t be friends with their colleagues. How do you discipline the nurse that arrives back 45 minutes after her lunch break finished if on the previous Friday night you were clinking two glasses of Prosecco together? 

Managers can create an association with the rest of the team; they can care and have a genuine personal interest in their colleagues. However, they can’t be friends with the team. A practice manager has to have impartiality and work without favouritism or prejudice. By keeping a professional distance with colleagues, an effective manager will be able to make decisions with a pinch of sentiment and a great authority without blurred lines. 

The outcome of this is that the team will have faith in the position of the whole group without fear of preferential treatment. An effective manager is one that is seen as impartial, decent, robust and more importantly fair-minded with the whole practice.

4. Honesty is key

Managers deal with many difficult situations, particularly staff issues and relationships. It’s important in these complex and delicate situations that a manager remains honest and is not persuaded to either ignore issues, hoping they’ll disappear, or fall into the trap of telling staff what they are hoping to hear. 

This is vital at appraisal, when all staff should receive accurate, legitimate constructive advice and – where appropriate – criticism. As a manager in a busy environment it can be tempting to take the easy option and ignore demanding situations, even occasionally to tell a white lie. It is so important the manager promotes a culture of openness and honesty. This will then filter down throughout the whole team. 

The same attitude works well with patients. Practice managers that create an approachable and receptive environment tend to receive fewer complaints and solve problems swiftly with minimum interruptions.

5. Be engaged

Working in an environment without engagement is futile. A good, effective manager is interested in the organisation and has an enthusiasm to make the practice a better place. An effective practice manager doesn’t only concentrate on their immediate surroundings; they get involved in the community and the wider society.

Practices are being pushed to work in federations and clusters, which can seem cumbersome at times. However, giving attention to community developments and being enthusiastic about what is important to patients will help keep the practice manager dedicated to their job. 

Practice managers can be involved in many ways, from local practice manager groups to health board initiatives. Being passionate, having a voice and taking an active part in issues that are important to staff, surgery and patients will improve the morale of the manager and create an energised team.  

6. Streamline sources of NHS information and news

In order to be effective, practice managers have to keep calm. The daily bombardment of emails can feel overwhelming; a good manager will quickly prioritise the important emails and hurry the trash emails to the junk box. 

It’s important that managers keep up to date with health and safety and personnel issues, along with clinical governance. However, you can quickly feel overloaded by information. Spend a few minutes every day catching up on what’s going on in the NHS – and the wider world of current affairs.

Subscribe only to sites that are legitimate, unbiased, trustworthy, up to date and likely to make a positive difference. In the long run, knowledge is the key to remaining inspired and working efficiently.

7. Understand the art of delegation 

Delegation is the key to successful management and will make your life easier on a daily basis. Practice managers can sometimes feel they need to do everything. However, this isn’t effective management. 

Good managers delegate. It’s important to identify skills and strengths in the existing team. The quiet receptionist may have excellent Excel skills or the administration worker may shine when dealing with stock and rotas. 

Some nurses may have a specific interest in research and may want to lead a project and its co-ordination.  Many practice managers report covering the phones during busy times or opening post because of minimal staffing levels.

This is expensive for the practice; it’s far more effective to staff the practice adequately. Managers can sometimes see delegation as a weakness but this is untrue. A strong, confident manager delegates wisely.

8. Have a common goal

Encourage your practice to have a common aim as this will promote teamwork and a unified environment. Some practices choose a charity every year to fundraise for. The common goal unifies the entire team. Fundraising for a charity can also include patients, which brings together the provider and the community. 

The charity work could encourage staff to take on new challenges, and also creates a positive profile for the practice and an ethos and culture that will be attractive when you need to recruit. 

9. Use technology to make your life easier 

Practice managers shouldn’t reinvent the proverbial wheel. Clinical systems these days are highly capable. There is plenty of software such as Docmail or SMS texting that can send out information to patients in minutes rather than hours. 

Practices should invest in a good website that can provide comprehensive information to patients at the touch of button, along with access to online prescriptions and appointments. Computers can occasionally feel like the enemy, but when used appropriately they can save a mammoth amount of time. 

Create a newsletter to get a lot of information in one place, then send it electronically to an online patient participation group. Add a signature to your email, letting everyone know your current health campaign.

10. Encourage staff to solve their own problems

The most valuable attribute for being an effective manager is to spread encouragement among your team. Give confidence to staff and persuade the team to take responsibility and learn to problem solve. 

Managers often come back from a holiday to be told the printer has broken or the toilet is blocked. Unfortunately, managers can sometimes be seen as the ultimate answer to every crisis and staff can forget to use their inner resources. 

Practice managers should ensure there is a good business continuity plan, along with an up-to-date list of important numbers that is easily accessible to all staff. The listing should include the plumber, electrician, IT specialist, phone system technicians, water board and health board. The list should have emergency numbers for when something goes wrong. 

Support staff to take the initiative. Avoid criticism and give plenty of backing to staff resourcefulness. This should, over time, create an independent workforce, making you
a more effective manager.

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