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Strategic planning roles for general practice managers

1 June 2006

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Wendy Garcarz
MA DipEd DipTM
E [email protected]

Wendy is Sales Director of Train4Health, a Statutory & Mandatory e-learning and testing system designed specifically for the NHS and social care. She is an organisational development specialist and architect of learning organisations and has authored several books and publications, including:

  • Make Your Healthcare Organisation a Learning Organisation. Oxford: Radcliffe Medical Press; 2003.
  • Statutory & Mandatory Training in Health & Social Care. Oxford: Radcliffe Medical Press; 2005.

For further details visit:

Strategic planning is concerned with the long-term direction and effectiveness of an organisation. It involves matching the activities of the organisation to the environment it operates in. To be successful in a changing environment, a practice needs its leaders to have a clear idea of their purpose and what outcomes they want to achieve, and some idea of how these can be achieved. It is inevitable that strategies are influenced by the beliefs, values and principles of their leaders.

Strategic planners make strategic plans  in order to:

  • Achieve some benefit, be it a financial benefit, a benefit to the workforce, and so on.
  • Position themselves to deal with change and uncertainty.
  • Identify and manage risk effectively.
  • Ensure corporate governance is observed.
  • Define boundaries.
  • Explore diversification.
  • Combat problems.
  • Effectively manage resources.
  • Meet the expectations and demands of key stakeholders.

Strategy depends on the operational management and decision-making within general practice to translate it into everyday actions, thereby making it tangible to the whole of the team.

Strategy also has its own language (see Box 1 for some examples).


Strategic managers need to understand and use the language if they are to have parity in a multiprofession environment. Failure to do so simply accentuates their differences, leaving others to make assumptions about their levels of ability and competence. Practice management as a leadership role has gained much ground in recent years, yet there is still a significant number of NHS managers and clinicians who see the role as purely operational (often the same people who fail to recognise the complexity of practice management).

Everyone working in a practice needs to know what the practice’s vision is in order to understand the individual contribution that their role makes to the practice. Employees need a clear sense of direction to ensure that they understand what is expected from both them as individuals and their team. This shared vision represents the practice’s philosophy, its culture and how it intends to achieve its objectives.
A business strategy needs to be formulated by a senior person within the practice, someone with an in-depth knowledge of the environment and the key relationships that influence the practice’s progression and business success. This is an ideal job for the practice manager.

In an average-sized practice (10,000 patients plus), the practice manager’s role should be around 60% strategic and 40% operational. The larger or more complex the practice, the more strategic management is required, but due to the nature of practice management there will always be an operational element to the role.
The questions that practice managers should ask themselves are:

  • Who is currently responsible for the strategic planning in your practice?
  • Are you in a position to devise a business strategy that ensures effective and profitable operation of the practice?

These are the questions that strategic managers need to answer to ensure that their the practice has a robust strategy setting out the future direction. Assessing and managing risk is an essential component of business strategy and an effective way to embed it into everyday practice.

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