Practice managers should be placed at the heart of consultation and decision-making processes if health reforms proposed by Lord Darzi are to succeed, the Institute of General Practice Management (IGPM) has said.
In its response to Lord Darzi’s independent review of the NHS in England, the IGPM described the report, published earlier this month, as ‘timely’ and as having ‘forward thinking proposals’.
However, the practice manager representative body warned that without a greater focus on management and non-clinical roles or easing the financial pressures surgeries face, proposals ‘may falter at the first hurdle.’
The IGPM set out seven concerns for policy makers and NHS leaders to carefully consider.
First, it highlighted that Darzi’s focus on increasing clinical roles was ‘commendable’ but overlooked staffing shortages in non-clinical roles, such as practice managers, receptionists and admin staff, who are ‘the administrative and operational backbone of primary care’ but often forgotten in workforce strategies.
The IGPM warned that ignoring the challenges surgeries face in hiring for these roles, means ‘efforts to bolster clinical roles will not translate into improved patient care.’
The body also welcomed opportunities for collaborative working, with a move towards integrated care systems. But it added that practice managers should be seen as ‘key stakeholders’ in this process, since they carry the knowledge and expertise needed to make that a success.
‘For the shift to integrated care to succeed, practice managers must be consulted and empowered to influence decision-making at a system-wide level,’ the IGPM’s response said.
Implementing new technologies and models of care requires significant upfront investment, the IGPM also explained. Yet with many practices already operating on ‘razor-thin margins’ , it called for any resources to be ring-fenced and easily accessible to practice managers, who are the people making the changes on the ground.
At the same time, it has urged Lord Darzi to ensure practice managers are not overburdened with bureaucracy, and that reforms don’t push workload down the line from GPs to them.
‘The Darzi report champions a reduction in administrative tasks for GPs, but this cannot come at the expense of an already overstretched practice management workforce.’
And neither should non-clinical staff be excluded from wellbeing support, a key positive theme in the Darzi report, it said.
‘In an environment where burnout is increasingly common, additional support for staff wellbeing is essential – not just for GPs, but for the entire workforce’.
The IGPM was critical of the decision to withdraw funding for the wellbeing and coaching service ‘Looking after You’, which it says has left some areas with no access to free support, and staff feeling that the ‘NHS does not care about the workforce.’
Finally, it welcomed Darzi’s call for increased investment into general practice estates and said that this would accommodate growing patient demand and improve the conditions for those working in primary care.
However, the IGPM said that the current NHS strategy had been too focused on hospital buildings for over a decade, which had left ‘the general practice estate unable to keep up with the modern demands of our patients’.
The institute concluded that without addressing the core issues of funding, staffing, and the administrative burden, the proposals put forward would not succeed.
‘The success of any healthcare reform depends on its implementation on the ground, and practice managers must be given the tools, support, and recognition necessary to make these changes a reality,’ the IGPM said.
