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LMC Conference: practice managers have “key role” in primary care future

12 June 2009

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GPs will need to invest in “high-quality practice managers” to run a reorganised general practice of the future, a leading GP told delegates today (12 June 2009) at the national LMC Conference in London.

Introducing a key debate on the future organisation of general practice, Dr Nigel Watson, a member of the BMA’s GPs’ Committee (GPC) and chief executive of Wessex LMC, said that, as general practice moves away from traditional individual partnerships towards alternative models such as collaborative networks of practices, managers would have an increasingly significant role to play.

A motion welcoming the Royal College of GPs’ (RCGP) proposals for “federations” of GP practices working together while retaining their individual contract independence was passed by the conference.

Last year, the RCGP put forward the proposal for federations, arguing that this would ensure collaboration, rather than competition, between practices, while still delivering more and better services for patients.

At this morning’s conference, Dr Watson said that “change is inevitable” and that, rather than wait for government directives, GPs should lead the process of change to ensure greater choice, quality and access for patients, while still aiming to preserve continuity of care and the GP/patient relationship.

Dr Peter Boffa, a GP from Croydon, told delegates that a federation of 16 practices had been set up in his area, including his own surgery, and that this had enhanced patient service while retaining the “independence and individuality” of each practice.

However, not all were in favour of such an approach. Birmingham GP Dr William Walker argued against the motion, saying that practices that were members of federations would “always put self-interest before the group”. At the same time he said traditional GP partnerships were a “dead duck”.

One doctor objected to being “managed centrally” and said GPs were best off as independent contractors – “we should not erode ourselves by having too many salaried GPs,” he said.

While the conference then voted in condemnation of certain “unfair and unfavourable” working conditions for salaried doctors, it also voted against a motion calling for the conference to “deplore the principal/sessional split in the GP medical profession, which it sees as detrimental to the future of the profession.”

Do you think federations of practices working together will mean a greater role for practice managers? Your comments (terms and conditions apply):

“No – I think this would mean individual practices would not have their own managers but inevitably, a type of “area manager” would emerge who would look after a group of practices, in the same way that groups of practices commission services, form buying groups etc so they would jointly commission a manager to work across the group. In that way, some managers would prosper and some would see their jobs disappear” – R Panton, Dorset

“No. I think it will be an opportunity for practices to reduce the number and improve the quality of managers and to introduce shared services to cut costs” – Name and address withheld

“Yes, more co-ordination and cross-information. It is a rather difficult job, where contact with others who deal with the same types of problems can be shared” – Janet Krol, Surrey

“There is a continuing and expanding role for the practice manager. They have become key over the last 10 years to the function and survival of practices and essential to PCTs in taking commissioning forward. However, there are two major problems, the first is the diversity of the PM role and the ongoing professional development, which I believe can only be achieved through a totally independant and PM-run professional organisation, which can then lay out a career pathway and fight our corner for proper recognition. Secondly, PMs are key to providing the finacial stability within practices and controlling the financial stake in individual practices and the wider clusters” – Mike Robinson, Barnsley