How can PMs lead increasingly complex change successfully and sustainably? Manchester GP and leadership coach Dr Robert Varnam reveals his tips

Practice managers have always been at the heart of successful general practice. And they’ve always been expected to be many things to many people. A typical week covers HR, rota planning, health and safety, financial planning, bookkeeping, chairing meetings, sorting suppliers, being a shoulder to cry on – and more. Over the years most managers build up their skills and confidence to handle all these day-to-day management challenges.

In addition, it is increasingly expected that managers should be experts at change leadership. Yet most practice managers have had little or no training or coaching in this area.

Leading change is often one of the hardest things managers do, and one of the most disheartening. It’s either depressing or encouraging to know that you’re not alone –worldwide research shows that most efforts to lead major change fail, even with a clear plan and good resourcing.

When there are changes to be made to how we work, or new services to introduce, we put a lot of effort into developing great plans. Yet good ideas and detailed plans aren’t enough, w we also need to engage and inspire the team, and then support them through what is often a long and bumpy journey. Increasingly, practice managers are being expected to do this not only for their own staff but across the PCN, adding the challenge of leading people who don’t even work for you.

Take heart – we’ve learned a lot in the NHS over the past 15 years about change leadership, and there are some very useful lessons for us in general practice.

In particular, we’ve learned that leading change works better if you start with building a shared purpose for it, and one which is about more than just meeting targets. Connecting the work with what matters to people at a deeper level helps the leader to tap into their own motivation to commit.

The same can be true when you face resistance to change. Just pushing harder doesn’t work very well and can be exhausting. But asking ‘why?’ can help a change leader see behind the resistance, and highlight personal concerns that can be addressed without creating conflict.

Understanding and connecting with the personal motivations of your team, creating a shared purpose for change, and rolling with resistance will all help you get more done with less pain.

This is about leadership, not just management, and it will also help strengthen team morale in the midst of all the busyness of today’s general practice.e