As an HR Consultant in primary care, I am lucky to have scores of practice managers, business managers, operations managers and PCN managers as valued clients. I am always in awe of these hard working, dedicated and seemingly bomb-proof individuals who keep our GP services running, even despite the pandemic.
However, over the past few years I have become increasingly worried about the practice management profession, as the scope of their roles continues to expand and the pressures and demands on them creep up. I see these fabulous professionals running around caring for their staff, offering support to their GPs dealing with angry and frustrated patients, working to help develop PCNs, organising the next round of Covid vaccinations and responding to the next wave of financial and other challenges. And I often ask myself, ‘Who looks after the practice managers?’
Some of the more frequent problems I see PMs face, include:
- Working long hours without rest breaks,
- Being unable to take leave without being disturbed,
- Being 24/7 on call,
- Organisational structures that don’t allow them to delegate effectively,
- Little investment in training, or when there is online training offered, is almost always interrupted,
- Practice managers being placed in the middle of partnership disputes and difficulties and being expected to mediate a resolution,
- Not receiving appraisals regularly.
On a positive note, I also see lots of good practice and work habits being carried out. Where businesses do proactively look after their most valuable resource – their practice managers – what is it they do? Here is what I have observed as being most effective:
- They implement succession and business planning. This is critical to ensure that if the practice manager is absent, the practice can continue to run. It also ensures there is a suitable organisational structure that supports the main functions the PM oversees. It involves setting clear objectives for the practice and the PM; developing career paths for the PMs of the future; supporting the PM in their professional development; and puts partnership forward as an option (where appropriate) for the most talented and skilled PMs.
- They ensure that partnership agreements set out mechanisms for dispute resolution that do not involve the PM.
- They listen.
- They address and manage conflict early.
- They provide regular feedback on performance be it positive, negative or in-between.
- They provide managerial support and have an oversight of the business without micromanaging.
- They have a budget in place that allows PMs to access the professional support they need, for example, accountants, HR, legal and any training or development programmes that may be suitable.
- They keep track of working hours, annual leave and take action if there are concerns about workload and risk of burnout.
I would encourage you to start asking your GP partners to recognise that there are things that can be done to alleviate the stress on practice managers and then look at putting in place some of the measures listed above. This will help ensure that the practice managers of today can develop into business leaders of the future.
Liz Willett is Head of Business Partnership at Kraft HR Consulting Ltd , which works closely with practices, federations and PCNs in the Midlands and further afield.
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