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by Mollie Fraser-Jones
10 February 2023

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PM of the Year 2022: from premier league football to improving healthcare for the homeless

Martin Turner, crowned Practice Manager of the Year 2022, only joined the health sector and Staveleigh Medical Centre in Cheshire three years ago having previously worked in the recruitment industry.

In that short time, he has achieved an impressive amount. Not only has he helped get several local health initiatives off the ground – one of which has directly reduced pressures on demand – last year he was also appointed PCN manager to Stalybridge, Dukinfield and Mossley PCN.

In an interview, Mollie Fraser-Andrews finds out why a career in practice management appealed and about some of the new services he has helped create.

First of all, how did you get into practice management from a non-healthcare background?

I joined the health sector in December 2019 just before Covid kicked in, for both personal and professional reasons. Staveleigh Medical Centre took a huge gamble hiring me as practice manager, especially since it was a time when there was massive change happening across health services.

I had been a senior manager at a nationwide recruitment and staffing company for eight years. I was introduced to the world of healthcare as my fiancée and some of her family work in this area (my fiancée is also now a practice manager). I felt I needed a complete career change, and after hearing about some of their challenges at work, I became more intrigued about practice management.

What strengths make you suited to a career in practice management?

My job used to be staffing for large-scale events such as Premier League football matches and the Commonwealth Games. A lot of this work was people-based, so the transition to practice management seemed natural. Healthcare organisations can fall into the trap of recruiting people only from the health sector, but the risk is they bring the same solutions that everyone else had. I think my experiences from a non-healthcare background give me certain strengths and advantages that allow me to see new solutions to problems facing practices. I can offer diversity in my approach and outlook.

What motivates you on a daily basis and how do you avoid feeling overwhelmed by the pressures of the job?

My motivation has changed as I’ve matured as a manager. I used to be driven by my own success and the success of the organisation. More recently though, and because of moving to healthcare, this has shifted so it’s more about the success of others. I really enjoy interacting with patients and look forward to this much more than the paperwork on my desk!

I’m keen on tackling inequalities but not so much on hitting targets. I know that they are important to the NHS, but I want to reach the 20% of people that never come forward for screening, or don’t know how to access healthcare at all.

As a manager, I think it is important to support staff personally, as well as professionally. I’m proud of our working environment, which we are always trying to improve. We organise group activities, such as runs around the local area and walks at the weekend, which can be real morale boosters.

I think it is easy to get overwhelmed and worry a lot about your job. I’ve heard the phrase that worrying is like a rocking chair, it gives you something to do but you never get anywhere. I just think, do what you can because you can only provide people with as many tools as you have available.

What would you say to someone interested in making the jump to practice management from a non-medical background?

It’s important to be reassured that while experience and knowledge can be gained or learned, it is your way of thinking that is crucial. It is easy to feel intimidated by all the medical terms, but this feeling goes away as you learn more. You can bring value with your experiences and then learn the rest as you go.

Moving onto your work as a practice manager, can you tell me about talk about the 111-style scheme that you helped to implement?

Launched in Summer 2022, our 111 style-service is called ‘Personalised care planning for high intensity service users’.  It is a paramedic-led service that exists for patients who regularly rely on calling 111 and 999. It aims to reduce the frequency of calls they make to urgent or emergency services, as well as hospital admissions. The PCN already employed a paramedic to work closely with patients and we decided to recruit an additional one so we could run this service.

Each of the nine practices in the PCN was asked to provide a list of patients who are high service users, so we could identify the top 250 patients that fall in that cohort.

The two paramedics are based at our PCN’s Healthcare Hub (a facility that offers our patients a host of NHS services) and are available on the phone to offer support to this specific group, helping them navigate the problem they have, and referring to the patient’s care plan to provide reassurance. The patients can also attend the hub and speak to the paramedics and we offer home visits to prevent hospital admission, where appropriate. Most of these users are elderly or have complex health needs, so the service allows us to reach out to them before they call 111.

 In many cases, these patients are socially isolated and it’s about building personal relationships with them, so they feel their health needs are being met.

Eventually, we want to try and expand this scheme and target other groups we think may benefit, such as complex care patients (moderately frail) and those with social prescribing needs.  

The service has been successful so far. It has led to a decrease in the average phone wait time for patients calling in to Staveleigh from more than 20 minutes to less than two minutes – an improvement of 90%.

Do you have any advice for other practices wanting to develop a similar service?

I think it’s easier to set this kind of scheme up when collaborating with other practices or as a PCN. Because I am also a PCN manager I’m able to look at economies of scale, which helps when trying to get funding.

We bid for funding for this project from the local enhanced services pot. Bids were being requested for services that offered proactive, personalised, and preventive care for an identified cohort of patients on a risk register. Our scheme fit that criteria and funding for this PCN wide project was approved by Tameside ICB.

It boils down to accepting that patients who are high service users need more time, and whether your practice or PCN wants to invest the time to provide a more holistic approach that may result in patients calling less frequently.

You also helped set up a homelessness outreach project. Can you explain what this involves?

Like with the 111 initiative, this is a PCN-wide scheme. We launched it last April. It came about because of the hard work of an advanced clinical practitioner based at one of the other PCN practices called Laura Lyons, who is passionate about helping the homeless. She should take full credit for the project.

Essentially, the project is about identification, flagging up on practice lists that a patient is homeless, as well as trying to get those not registered with a practice signed up so they can access healthcare.

All nine network practices have gone through a ‘homelessness accreditation’ process with a not-for-profit organisation called Homeless Friendly and made a pledge to remove the barriers homeless people face trying to get healthcare. All the practices have received training on issues such as making registration easier, altering the practice environment to make it more accessible to the homeless and being better at recognising homelessness.

Laura engages with homeless patients directly and has built relationships with almost 100 homeless people in the area. She’s spoken to more than half, providing health information and support on safeguarding, clean needle use and immunisations, as well helping to diagnose health problems. We try and offer a personalised health service, so we register people ourselves as they might be reluctant or might not be able to do the form filling. These issues can apply to asylum seekers too, we are not interested in their background, just them and their health needs.

Laura works on this one day a week. We secured funding for all this work through our local ICB. Again, I think it is easier to work jointly as a PCN to develop schemes such as this one, since you are more likely to get funding approval.

It’s not always about money or resources though. One way practices can make a start is to have a simple code on their clinical system that signals a patient on their list is homeless and might need more support. With the cost-of-living crisis, many people are struggling more, and practices should want to be there for them as much as possible.

Read more about the Practice Manager of the Year nominees from the GP awards ceremony here.