Practice manager Pete Woodward reveals the two non-clinical roles that have been pivotal in freeing his time to focus on strategy and have strengthened the practice in the process.
The demands on practices are higher than ever, with no sign of easing. Alongside relentless patient need, general practice has undergone major change. Two recent examples of this are the contractual amendments introduced in October, requiring practices to provide online access, and the growing emphasis on neighbourhood working in the 10-year plan.
The result is that the practice manager role looks fundamentally different compared with even five years ago.
Practice managers must find ways to prioritise workload and protect time for what matters most: our people and our patients. Without that, there is a risk of burnout, financial instability, and missed opportunities to improve outcomes.
So, how do we do that?
I joined my practice, serving 11,800 patients, in 2021. At the time, it was just an assistant manager, who was a reception manager temporarily filling the gap, and me. To move forward, we redesigned the management structure.
There were two roles that proved transformational and may offer similar benefits for your practice: the admin/personal assistant and the patient experience manager.
Admin / personal assistant
We introduced this role to address management overwhelm. A practice manager is running a small business, with responsibilities spanning finance, HR, marketing, governance, operations, facilities, and health and safety. To delegate tasks that didn’t require practice management input, we needed clear, accountable processes.
A key part of this involved defining boundaries and expectations of the admin assistant role. We developed protocols and guidance so she could manage specific areas independently.
These included holiday approvals, patient recall for QOF, PPA claims, and preparing payroll for me to check and sign off. She monitored appointment availability, liaised with the ICB, arranged interviews, booked meetings, and produced minutes. She also triaged my email inbox and acted as the first point of contact for staff with queries about broken printers and staplers.
Individually, these tasks are small. Combined, they create a constant stream of interruptions to the average practice manager. Delegating them has been transformational in freeing up time and mental space for strategic work. In fact, this has been the single most valuable role we’ve created.
What to consider
Before you recruit your own, there are some things to consider.
Be careful about what you delegate. Keep tasks to those that don’t require complex decision-making; otherwise, you’re really recruiting another manager rather than a skilled assistant who executes your processes.
Consider the profile of the individual too. It needs to be someone who copes well with stress and who is adept at dealing with multiple parallel demands. Even so, you may occasionally need to shield them from practice colleagues who see them as the go-to problem solver for everything.
You may want to use an enhanced confidentiality agreement, as the role will likely involve access to HR files and other sensitive information. This helps reinforce expectations around information handling.
This role can provide a strong progression route for reception staff with the right skills and temperament. A working knowledge of EMIS and practice workflows goes a long way.
For us, the role wasn’t just about making my workload sustainable – it was an investment.
By reducing time spent on admin and increasing time spent on strategic development of the practice, we are generating more profit than ever. That’s because I now have time to properly implement a financial plan, forecast cash flow, evaluate initiatives, and start new ones.
The role has comfortably paid for itself – to the point that we recently expanded by appointing a second assistant to share the workload.
Patient experience manager
The second role that proved transformative was the patient experience manager.
Dealing with complaints can feel like a constant struggle. It’s emotionally draining and it can have the unintended consequence of generating more complaints if patients learn that raising concerns gets immediate attention.
In addition, there is a rising expectation that practices will engage with the community, organise and attend events, and collaborate with PCNs and GP federations. We wanted to protect our focus on strategic work while ensuring patient service didn’t deteriorate.
So, we recruited a patient experience manager.
Their remit covers anything related to patient experience: complaints, Friends and Family feedback, and biannual staff and patient surveys. They analyse data and present recommendations at practice meetings. They also create social media content to build stronger relationships with patients. This is all without the practice manager needing to be involved.
Taking the step to recruit this role isn’t without its obstacles. For example, historically, patients have felt they must always complain to the practice manager or they wouldn’t be taken seriously. So, it requires a change of mindset. I tend to explain it in these terms: if your computer breaks, you don’t demand to speak to Bill Gates! He employs a team of customer service experts who are familiar with the things you’re trying to do and are best placed to help quickly.
This is a massive change of mindset compared with only five to 10 years ago. But it’s an important shift given that the number of tasks practice managers are now responsible for has increased uncontrollably. It’s simply not possible to focus on all these areas and be available to everyone at all times.
The benefits
Since we brought this role in, our patient list size has grown, in part due to an improved reputation among our patients. This obviously means greater income via the global sum and is money that can be used to cover much of the expense of the role.
The hire has had a huge impact on my work. Now I only need to supervise complaints; data is prepared and presented to me and the partners so we can agree any changes going forwards, and the practice has a relevant social media presence – all with minimal input from me.
My time is freed up to focus on other strategic work, such as optimising our triage and appointment systems, which also helps to improve ease of access and patient experience. This proved vital when the online access contractual changes to online access came in on 1 October – the transition was much easier than it otherwise could have been.
At my practice, we run a ‘virtual’ patient participation group (PPG) with all patients as members by default. However, if your practice still has a more traditional PPG set-up, this role could also be responsible for running those meetings and liaising with patients. And, of course, if you had an admin/personal assistant, they could also do the minute-taking.
Conclusion
One point to bear in mind is that bringing in additional roles like these could risk creating ‘single points of failure’. In other words, if the individual were to leave or be off sick, there may be a situation where other people cannot cover the work.
However, practice managers should always be prepared to dip back into any tasks. And there’s some benefit to this too – I find it means I have a high level of understanding of what is happening across all the different areas of the practice.
Overall, these two roles in particular have been critical to the success of the practice over the last five years, and I’d recommend them to any practice manager.
Pete Woodward is managing partner at Cheadle Medical Practice and Alvanley Family Practice in Stockport, as well as running Woodley Village Surgery on a consultancy basis.
