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In conversation with… Daniel Vincent

21 March 2018

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General practice has been suffering from a range of factors, including underfunding, heavy workload and lack of GPs.

Léa Legraien talks to a practice manager to find out how he keeps his practice thriving.

Q. What makes your practice stand out?

A. Our fearless approach to innovation and change combined with a strong quality improvement methodology has helped us to stand out among an amazing crowd.

Q. What’s the key to successfully managing a practice?

A. Undoubtedly the team. In the modern NHS it is impossible for a single person to deliver the role and responsibility of a practice manager. You know you have a great team when it tackles personal and professional adversity together.

Q. What are the elements to become an inspirational leader?

A. Humility. I am here to serve my team and my patients. I would never ask my team to do something that I am not prepared to do myself. The problem we are facing in general practice is the weight of that business. We simply don’t have enough people and most of us have been carrying the weight for so long that sometimes it can feel like people are running out of steam.

Q. What’s your biggest achievement as a practice manager?

A. The implementation of the new models of care at the practice. Being involved in the NHS England Primary and Acute Care Systems vanguard was one of my primary motivators for joining the team at Ryalls Park Medical Centre. We have been given the opportunity to have some headspace and redesign the primary care services. We have implemented new roles, including health coaches and musculoskeletal (MSK) practitioners, and introduced new ways of working, such as twice daily team huddles that have revolutionised the way we work.

Q. What part of your job do you like the most?

A. Reception cover. I just love having an opportunity to be hands-on and really test the limits of the systems we have created. I have the greatest respect for our team who do this on a daily basis. I’m not sure I could hack it everyday.

Q. What are your daily challenges?

A. Meeting the expectations of our patients. I’m saddened to say that these expectations are increasingly out of kilter with what the system can afford to provide. This inevitably leads to frustration, disappointment, anger and aggression from patients. It just really hurts when all you are trying to do is your best for the patient.

Q. How do your primary care health coaches and MSK practitioner contribute to your practice?

A. They give patients the time and space to think and plan, with the aim of building their confidence and activation to a point where they can address issues one step at a time. Our brilliant MSK practitioner has the time and experience to give our patients a full work-up and find the most appropriate options to meet their needs. His appointments have freed up GP time, enabling us to extend our routine appointments to 15 minutes.

Q. How are you planning to develop your practice?

A. I am worried about what the future holds. Simon Stevens [chief executive of NHS England] said: ‘If general practice fails, the NHS will fail.’ I couldn’t agree more. We have benefited from some great training – arranged by our local medical committee and funded by the General Practice Forward View programme – but, if I’m honest, that’s it. I feel working at scale is inevitable, but fear this could be the end of agile, flexible and dedicated primary care units. We will need to create a model that replicates the goodwill that is generated not only by the partners but also by the teams.

Daniel Vincent is a managing partner at Ryalls Park Medical Centre, Yeovil, a CCG representative for South Somerset Federation and NHS England local coach for the 100-day Trauma and Orthopedics Challenge.