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by Stuart Gidden
17 October 2007

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Back to Birmingham

It was great to see those of you who attended last week’s Management in Practice Event in Birmingham. I couldn’t believe it has been a whole year since we launched the Events in the same venue – the NEC – how time flies!

Well, most of the time it does. Other times it goes a little slower … I had hoped to write my summary of the Event sooner, but sadly poor health intervened and I was struck down by bronchitis the following day. Unfortunately, my GP practice doesn’t open on a Thursday afternoon so I had to take a trip to the nearby walk-in centre.

Or perhaps, I mused as I remained in the waiting area for what seemed like many millennia, it should be renamed the “sleep-in centre”? It took nearly two hours for me finally to be seen by a nurse practitioner, and, what with my chest feeling like it had passed through a cheese-grater, I was not a happy bunny.

I was unfortunate also to become ill on a day when, seemingly, every small child in North London needed medical attention. Surrounded by toddlers dancing, stamping and screaming around me for nearly two hours, a thought occurred: why not create general practices (or, indeed, walk-in centres), specifically for the over-18s?

Does this sound like a good idea to you? I imagine that the sound of noisy children is a constant background score for many of you. What are your tips for dealing with this?

Anyway, the point of this introduction is to say that one single trip to the primary care arena can throw up many issues, as in this instance – GP opening hours, the challenges that walk-in centres face, and crowded waiting areas – and the Management in Practice Events are no different, with a wide variety of topical general practice issues under discussion in one day.

Helena Jordan from the Working in Partnership Programme (WiPP) kick-started proceedings with a valuable keynote talk on how practices can build self-care pathways for patients (while waiting to see a medic the next day, self-care was certainly an option running through my mind). The challenge for the practice manager here is of course ensuring synergy between the many members of the practice team that will care for patients with long-term conditions, and ensuring consistent communication with all.

The issue of communication was pivotal to Patricia Gray’s popular talk, entitled “Herding cats – managing partners”. A regular author for the magazine, ex-practice manager and primary care adviser Patricia gave a comprehensive look at the sensitive issue of managing potential – or actual – conflict in practices between the manager and the partner/s, and advice on how to help resolve any differences.

For me, the highlight of the Event was the panel session, which gave you your chance to submit questions to an expert panel, which included Patricia, training director Jill Burke, AMSPAR President Elaine Guy and primary care provider Graham Poulter.

Questions submitted revealed concerns about the changing face of primary care and the practice manager’s role. One manager asked: “What is the biggest risk to general practice as we know it?” For Jill, who sees commercial competition as the biggest threat, the answer was simple: “Tesco”.

Indeed, as chair Wendy Garcarz argued, recent newspaper suggestions of patients being able to register in two separate practices could lead to the end of the list system – which would mean open competition for practices to attract patients.

What do you think to this? Currently no plans are in place to do away with the list system, but some – such as Roy Lilley at the London MiP Event – argue that patients would benefit from open access to any GP surgery, which could be made possible thanks to electronic health records.

But as Wendy says, the flip side of the coin is the competitive marketplace – is primary care really the place for this, and could this mean greater privatisation? We’d love to hear your thoughts on this vital issue.

As we reported in a recent news story, the panel session also led for a call to practice managers to become more vocal on general practice developments, as one manager bemoaned the fact that “government policy is rolled out without any consultation with practice managers”.

Do you think practice managers need to speak up and consult with policy makers more? As Wendy said at the Event, GPs and nurses have active political representatives – as we’ve reported recently, the British Medical Association (BMA) is actively making GPs’ opinions on opening hours and the 2004 contract changes known to the government – but practice managers seem to lack a unified, political voice of sufficient volume. Do you think this should change?

This is an issue we’d love to explore at Management in Practice. We want to hear your opinions on all the issues affecting you – opening hours debates, private providers, the practice manager’s role – which is why we shall soon be inviting you to respond to an online survey. And in the magazine, we’ll also be exploring ways that you can get involved and make sure that policymakers start listening to practice managers (you can always get things off your chest by writing to us at [email protected]).

After all, everyone – including patients – will suffer if those of you running the surgeries start to become disaffected with primary care.