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Practice managers reject ‘genuine listening exercise’

15 June 2011

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Practice managers yesterday expressed feelings of disengagement from the government’s ‘listening exercise’ in England, despite assurances that views had “genuinely” been taken into account.

At the Management in Practice Event in Manchester (14 June 2011), NHS Future Forum member Dr Robert Varnam told more than 450 practice managers and GPs that the government’s amended health reforms usher a “new world” of empowerment for primary care, despite being “possibly the most risky thing anyone’s ever tried with the NHS”.

Dr Varnam (pictured), a GP in Manchester and the RCGP’s Clinical Lead for Commissioning, told delegates that practices will no longer be “cogs in a machine” following directions, but their new commissioning role means they will be “guardians of the health service”.

He acknowledged that there has been “a lot of uncertainty about where we’re heading” but, referring to the NHS Future Forum report published yesterday (13 June 2011) and the government’s response, added: “We have at least got some direction now.”

Dr Varnam insisted that the NHS Future Forum report accurately reflected the issues raised in its listening exercise, launched on 6 April.

“What’s come out is pretty much a summary of what everyone’s been saying for quite a long time,” he said. “Concerns about the pace of change, about imposing change from the centre versus localism, about how you do governance and who should have representation – I think these have been themes that have been been around for quite a long time and are crystallised in this report.”

The exercise had been a “big thing”, he added, pointing out that more than 200 listening events have taken place attended by approximately 7,000 people, with a further 25,000 sending views by email and 4,000 sending questionnaire or website responses.

“It’s been really interesting to see how apolitical this has been, in that this has genuinely been a listening exercise,” Dr Varnam, said.

However, when more than a hundred practice managers were later asked if they believed their views had been heard, only one raised their hand.

Conference chair Steve Williams, a practice management consultant, said that he had attended a listening event but felt that managers’ views were not taken into account. “Sadly I had my voice quelled and it wasn’t for a want of trying,” he said.

A spokesperson from the Department of Health said it had no figures on how many of those who attended the listening events were healthcare professionals or members of the public, and so was unable to confirm the number of practice managers in attendance.

What’s your view? Do you think the government has listened to practice managers’ views on NHS reform? Your comments (terms and conditions apply):

“No, the fact that they did not target practice managers specifically leads me to the belief that they did not want our views. I put my view to our local GP when she knocked on the door and had an impression of no interest. Until the government spells out to all of us that the NHS has limited funds, and choices have to be made about treatment and where it can be offered no one will win. These are of course my own views and not necessarily those of the practice” – David Wharton, Hampshire

“If they have they haven’t asked me” – Jenny Webster, Oldham

“In a word, no – so no change there – and if they had they would have ignored them in any case except for those that agree with the govt line” – Name and address withheld

“The government have certainly overlooked the expertise among PMs and in the same fashion most PBC set ups have done so as well. Ours in Kent will not even allow us representation on the board but see us as merely advisory” – David Shaw, Kent

“I don’t think the government realised it NEEDED to listen to our views. Practice managers are still seen by many across the NHS as middle-aged ladies who have come up through the ranks and generally do what their GPs ask of them (in between knitting jumpers and riding their bicycles around town). The truth is that there are now a significant number of professional managers (including some of those who’ve come up through the ranks, by the way) who are developing their practices and managing an ever-changing workload with great success. Many of us have come in from outside the NHS, often with management experience at more senior levels. We are used to questioning our leaders, acting devil’s advocate where necessary – and we know how to make things happen. We can write reports, give presentations, analyse data, negotiate contracts, run major marketing campaigns, develop strategies, business plan, manage and develop staff, recruit, budget, develop policies, effectively handle complaints etc etc but we are still struggling to make ourselves heard (and our contribution recognised) in the NHS. In this area, the practice managers were all removed from the PBC Board (just before the listening exercise started). Even our own GPs sometimes don’t seem to realise what potential they hold in us” – Jacky Slator, Runcorn

“Practice managers have been ignored in the whole exercise. We have not had a voice, not been properly considered yet will be expected to pick up the pieces. I have been to a number of events recently and the most common chat has been about how can we get out!” – Mike, South Yorkshire