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Practice managers: making the difference to responsiveness

9 April 2010

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The NHS Practice Management Network (PMN) is a national community of general practice managers. The aims of the network are: to influence the development of policy; to ensure that, as key players in the local NHS, practice managers are engaged, involved and consulted; and to share our wide experience as business managers with our colleagues in practice management and with others in the NHS. We also aim to promote excellence, provide practical support and identify examples of good practice

Access and responsiveness remain key policies, affecting practice and patient issues. In 2008, when the Department of Health (DH) set up the national GP Access and Responsiveness programme – to help the NHS to be more responsive to different patient needs – practice management was the first group they turned to.

“When we needed to find examples of best practice, it was the practice manager who provided it, and when we considered how other practices would implement a service change it was obvious that it was the practice manager who would be primarily responsible,” said Dr Mike Warburton, National Director for GP Access and Responsiveness.

This programme has continued to work alongside groups of practice managers, as well as patients and primary care trusts (PCTs) to deliver a range of practical resources. All the practical resources developed can be accessed free from the Practice Management Network (see Resource).

For practice managers, by practice managers
Two networks worked closely with the DH Access and Responsiveness Programme: the NHS Alliance Practice Managers’ Network and the new Practice Management Network, bringing together all seven major primary care organisations.

“The drive, commitment and pragmatic approach of these managers have been central to the success of the programme, and with them we have developed a wide range of support resources,” said Dr Warburton. The resources outlined in Box 1 are all a result of this collaboration.


Responsiveness in primary care is more important than ever
The focus on responsiveness and accessibility will continue as PCTs strive to become world-class commissioners. When you combine this with more numerous and vocal patient groups, who themselves are working with providers that are striving, and being rewarded for, clinical and service excellence, further advances in responsiveness become very likely. And over the next few years, the quality and productivity agenda is going to make these improvements essential.

Practice-based commissioning (PBC) will also inevitably drive improvements in access and responsiveness. If you are jointly trying to manage your urgent care budget but your fellow practices are closed throughout the middle of the day and their A&E attendances and admissions are higher, an important discussion is to be had.

The cost of poor customer service
In other sectors it is recognised that poor customer service costs your business lost income.

Professor Merlin Stone, a leading academic in customer behaviour, has estimated that substandard treatment was behind organisations losing up to 20 million customers at a cost of £3bn in lost revenue, and that “organisations need to work harder to keep their patients.”(1) However, he maintained that issues surrounding customer experience could be remedied relatively cheaply. Customer care training for staff must be a cost-effective investment for primary care providers.

Project Horizon, part of the DH GP Access programme, involved working with practices to develop new ways of offering and communicating a great customer experience. Results and resources from this pilot project will be available on the Practice Management Network site from April.

Primary care has been protected from this “easy-to-switch” behaviour. However, as patients get more vocal, NHS Choices comparison websites get more widely used and patients expect the same service that they receive from other sectors, patients will start to really exert choice. Practices are already starting to see this, and know that to retain and grow their patient numbers they need to start being a truly responsive service.

Looking ahead, the role and influence of the practice manager must continue to grow. Practice managers working together must be a more powerful voice to shape primary care and also help develop and support each other.

Sandy Gower, Chair of the Practice Management Network, said: “The Practice Management Network, linked to effective local and regional groups, seems to be the ideal forum to help achieve this.

“Over the coming months, the network will develop and provide more and more resources, but to be really effective it needs your voice, your opinion and your input – so get involved, have your say and shape the network in the way you want and need.”


1. Baker R. Businesses losing customers from bad service. Marketing Week January 2010. Available from:…


Practice Management Network