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First 100 days as a practice manager: ways to make maximum impact in a new job

1 December 2023

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Former practice manager Gary Hughes sets out important milestones to aim for in the first few weeks of joining a new team

Your first 100 days as a practice manager in a new job is a critical period, so using this time as effectively as possible can set the tone and help shape success in the future.

This article provides you with a structured 100-day plan to ensure you get off to a great start. It’s arranged in three 30-day blocks, each with key goals to achieve in that period. At the end is a further 10-day period to reflect, review and make new plans for the future. It’s a programme to use as a guide rather than follow religiously. Every practice and situation is different, so be prepared to adapt as your own situation requires.

Why a 100-day plan is important

At the start of a new job there is a lot to be achieved. You need to get used to the requirements and expectations of the role and familiarise yourself with the workplace and colleagues, all while making a good impression. Everyone involved wants you to succeed, and with so much at stake the best approach is to eliminate risks with a plan allows you to smoothly integrate and make a lasting impact at the practice.

Before day 1

Ahead of your first day, it’s vital to learn as much as you can about the job and the practice that will help once you’re in post. If possible, meet your predecessor and the team. You want to build your knowledge of how things are organised, who does what, and what will be expected of you day to day.

Day 1 to 30

The first 30 days might be the ‘honeymoon period’, if you are lucky enough to get one. You should be focused on making a good initial impression and building on that to establish your credibility. In this first phase there are four areas to focus on.

  • Acquiring relevant knowledge

You need to gather as much information as you can, about anything and everything, that will help you in your role. Get to know the practice culture, who has authority, power and influence, which values are important and what challenges and opportunities are seen.

  • Building positive relationships

Get to know as many people as possible, the partners, clinical team, non-clinicians, the patient group and the important external stakeholders. One-on-one meetings with team members to understand their roles, aspirations and concerns can be helpful, as can having an open-door policy to encourage communication.

  • Achieving quick wins

While the first 30 days are about gathering information, you should also grab any opportunity for a quick win. Any improvements or small goals you can achieve early on, that meet with everyone’s approval will help you gain credibility and support, setting you up for greater success ahead. This  could involve applying your existing knowledge or skills to improve something that the practice hasn’t been able to do until now. Examples are improving the use of the practice software, streamlining an admin process or resolving a rota issue.  

  • Addressing immediate issues

There can often be someone in the team who will want to test the new manager. If that happens you should show you are ready to act swiftly and decisively, in the interests of what’s best for the team and the practice. If you identify any immediate issues, it is always best to address them promptly.

Day 31 to 60

In this second phase, you and others will want to see tangible results and that you’re making a positive impact on performance. With the first 30 days behind you, start applying your knowledge and relationships towards measurable and more visible results.

  • Setting your vision

It’s time to set the direction for the practice, and to share your ideas and demonstrate your leadership. Work with your team to build a vision and the long-term goals for the practice. Getting others involved will keep the team engaged and motivated, and their input will help you bring the long-term plan to life.

  • Building your team

A strong team is your most valuable asset, so address any team issues or conflicts and work on shaping a culture of collaboration. Show that you are committed to training and development by ensuring personal development plans (pdp’s) and training schedules are in place.  You should also create a plan for regular team meetings to keep communication flowing and everyone informed and engaged.

  • Meeting compliance and regulatory requirements

Making sure the practice is safe and meeting all its mandatory requirements is essential. Review the practice policies and procedures to make sure everything needed is up to date and in place. Make sure working practices align with the policies, and check evidence is being collected ready for the next CQC inspection.  

Day 61 to 90

Day 61 onwards is when you can move into implementing improvements that you have identified in your time at the practice so far. Taking a longer-term view, you should also assess and address any areas to ensure the practice will remain operationally and financially viable.  

  • Improving efficiency

Where you have seen, or others have flagged, administrative processes that are not working effectively, make the changes that will provide the necessary streamlining and additional efficiencies. Its vitally important to involve the team in the changes, and take their views on board, especially if they will be impacted by this.

  • Managing the finances

A key responsibility of a practice manager is to ensure the practice is on a sound financial footing. Conduct a financial review and evaluate all aspects of the financial performance. From this develop a budget to ensure the stability and a positive financial performance.

  • Business continuity and contingency

Updating the risk register and developing contingency plans for all identified risks and unforeseen challenges is also needed to ensure business continuity. Make sure there is a plan that keeps the practice resilient and operating should there be potential disruptions, emergencies or staff shortages.

 Day 91 to 100

Your first 100 days have probably flown by, and as you near the end it’s essential to measure your progress against your plan and use everything you have learnt to make new plans for the future.

  • Measure progress

Gather feedback from the practice team and use this to assess the progress you’ve made, and whether you’ve achieved your own goals. Make sure this includes feedback on your own performance and leadership so you can refine and adjust the way you’re working.

  • Make future plans

Hopefully you’ve had a successful start and you’re able to use this feedback to build a new strategic plan for the upcoming months. It should be a plan to achieve the vision and long-term goals you’ve been developing in these first 100 days, inspiring the team and further increasing your value to the practice.

Success in the first 100 days as a practice manager can lay the foundation for long-term success. You may choose to follow the plan exactly as described above  or make adjustments to meet your own and the practice’s needs. Whichever option you choose, having a plan in place will give you the best chance of having a positive impact.

Gary Hughes is the founder/director of Leadership in Practice and Portfolio Careers in Primary Care providing leadership and management development to primary care. He has been a practice business manager and federation director and has an MBA and a Post Graduate Certificate in Medical Education.