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Case study: the path from practice manager to premises consultant

1 December 2006

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Val Clinton
EC Harris

Val Clinton specialises in delivering new build and major regeneration projects on behalf of the NHS and private sectors. She heads the specialist health unit at EC Harris, providing expertise throughout EC Harris’ regional network of UK offices in London, Birmingham, Leeds and Manchester. The team also specialises in valuation and rentals, as well as securing complex planning issues for primary care initiatives involving medical and treatment centres for GPs

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As GP practices continue to expand, the role of the practice manager moves further into the spotlight in the wake of ever-increasing NHS changes.

But even if the challenges of running a “supersurgery” are well and truly under control, there are other opportunities arising for ambitious individuals to capitalise on such experience, as two former practice managers have subsequently discovered.

Jacqui Jones and Andrea Williams, who have around 30 years’ practice management experience between them, have carved a new and rewarding vocation in their life with a move into consultancy.

New horizons
The duo have jumped the fence and are now helping practice managers around the country fulfil major expansion plans or the refurbishment of their medical centres, as part of EC Harris’ specialist health team, based in Birmingham.

Speaking about her role, Jacqui Jones, who now has five years’ consultancy experience, said: “The transition to consultancy came about because I was ready for a new challenge and didn’t feel that pursuing my role as a practice manager would fulfil my ambitions.

“The opportunity arose when I came into contact with Val Clinton, head of EC Harris’ primary healthcare team, who offered me the chance of utilising my practice management skills on a larger scale. Since then, I’ve never looked back on what has proved an opportunity too good to miss. Timing was also crucial, as five years ago the rents and rates reimbursement played a significant part with just notional rents, meaning primary care effectively had noncash-limited funds available for expansion and refurbishment schemes. The whole team at EC Harris were rushed off their feet running schemes all over the country as developers took advantage of the investment opportunities. The more entrepreneurial GPs were also working with us directly to help them find appropriate sites for proposed new builds.

“But by 2003 the money pot had run dry, so the government decided that if a primary care centre needed money for refurbishment or rebuild it would have to bid and prove that the centre could deliver the service. Also, it came down to how desperate the surgery could look compared with the next medical centre up the road.

“We are now at a stage where the cash flow is still limited and the primary care trust has to produce a list of its worst-case scenarios of premises to establish how much money is available through their strategic service development plan.”

Relating to practices’ needs
The entrepreneurial spirit among GPs is, however, still present, as Ms Jones went on to explain: “We do have GPs who want to move with the times and are prepared to take guidance on how to better their medical centre. We’re also able to help them in structuring the funding and setting up a self-invested pension fund, when taking ownership of a new building.”

While there are similarities between the roles in the health team and the role of practice manager, both Ms Jones and Ms Williams are in agreement that they enjoy having more control over their workload. As Ms Williams said: “Both roles are very demanding and considerably stressful. As a practice manager, having responsibility for looking after the premises is actually a small part of the role. You have to wear many hats, and need to know a little about a lot. You are also controlled, in terms of what you can and cannot do, by the primary care trust (PCT).”

Ms Williams, who made the switch to consultancy less than a year ago after being practice manager of two large practices, added: “The benefit we bring to the EC Harris health team is that we understand the frustrations that practices suffer. That’s because we’ve been there and done that. This means we’re able to communicate on the same level with practice managers as we’ve been in the same boat.”

Mentoring role
In order to assist the transition between the two different roles, practice managers are assigned a mentor when they move into EC Harris’ health team, as Ms Williams explained: “Jacqui is my mentor, and it is great to have someone who has experienced both disciplines. I actually found my transition between the two jobs fairly easy, as I was concentrating on one aspect of my previous employment and specialising in that area. I now have the opportunity to see something through from start to finish, so it is inspirational knowing we are taking primary care forwards.”

Commenting on her mentoring experience, Ms Jones said: “I had been a practice manager for 10 years and was at the stage when I could do things with my eyes closed. When I began working with Val, she became my mentor and would give me mentoring sessions during my training to assist me. Initially, I did find it very challenging, but the ‘penny dropped’ after a meeting that Val and I attended. Afterwards, she told me that I had spoken the whole time throughout the meeting on a specific project, so I realised my move to primary care consultant was complete.”

While each project is very different, the same principles are applied from the outset. The initial questions practice managers are asked at the beginning of a project are therefore:

  • Can the building cope with what needs to be done?
  • If it can’t, the next steps are either refurbishment or new build.

Looking to the future
According to EC Harris, the effect of NHS changes on the way health services are being delivered today and proposed in the future is now impacting on the lifespan of buildings.

“The shelf-life of buildings has dropped, from 25 years down to 15–20 years. To be cost-effective, we advise practices to consider building extra space during the construction process, just as a shell. This can result in significant savings 10 years later down the line, when the practice finds itself in need of extra space,” said Ms Jones.

Looking to the future, the EC Harris health team are forecasting a massive growth in this area, following government proposals to shift NHS care from hospitals into the community. A further cash injection into PCTs is inevitable. Improved healthcare into the community cannot be delivered without improved facilities, which means enlarged premises to cope with the increased demand.