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by Valeria Fiore
8 February 2019

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The PM edit: Anthony Howarth in his own words

Management in Practice is speaking to a series of PMs on the front-line about what being a practice manager means to them.
Reporter Valeria Fiore talks to Anthony Howarth, business manager at West Gorton Medical Centre in Manchester about the challenges practice management poses and the future of the profession.

Q. How has being a practice manager changed since you first started out in the profession?
I feel the biggest change is that we are [now more] leaders than managers. However, I don’t think any practice manager should consider themselves as ‘an island’. This job is too big to do everything yourself. We need to be authentic, coach and empower staff so that we can trust them to deliver.
Q. When did you begin as a practice manager and how did you get into the role?
I graduated in 1999 with an art degree and had hopes of being an actor. However, I fell into full-time work, managing optician practices.
I then moved to NHS primary care in 2007 when I took the role of office manager to cover a practice manager on maternity leave. After she came back from maternity leave, I moved to another practice as a practice manager and have never looked back.
Q. What are the biggest challenges of being a practice manager today?
Practices now have to be more creative at generating income and practice managers [now need] to acquire new skills to be able to map processes to meet demand.
We have to constantly look ahead to seek out new opportunities. We need to be aware of the changes in the NHS and to try and pre-empt what is coming next.
It is hard to think outside of the practice walls while also managing the daily running of a practice and its staff.
Q. What do practice managers need most in terms of support and resources?
I feel practice managers need to be considered more in the wider NHS strategy. There is a great deal of talk around clinical leadership and how to develop these roles. Although this is great and is needed, I can’t help but feel it’s a little short-sighted.
Practice managers are excellent leaders. We multi-task every day on a variety of projects, we act as counsellors, business managers and caretakers – all rolled into one – and this list is non-exhaustive.
Practice managers are like a counsellor on a ship, someone for staff to talk to when they are out at sea.
I feel more investment is needed in developing practice managers to maximise their full potential and to build their resilience to retain them.
Q. What do you find most rewarding about being a practice manager?
I love encouraging my team to try new things and I try to implement new ways to keep them engaged in their work and in the practice.
I enjoy teaching my team new skills.
I find process mapping really rewarding in making staff question why we do things in a certain way.
Q. How do you see the future of practice management?
Working at scale will allow practice managers to become more specialised in certain role – focusing on CQC, performance management, quality improvement, or project management, for instance.
By sharing ideas and working across practices, we can support each other in so many ways and maybe prevent ourselves from reinventing the wheel.
I think this might be quite a steep change for some of my peers because we have been forced into an autocratic and isolated way of working for so long. This is where practice management development plays its part and I hope [we will see more of it] in the coming years.
Q. What do you think you would be doing today if you were not a practice manager?
In my youth, I always wanted to be an actor but my life has taken a different path. I really enjoyed studying my MSc and I enjoy teaching people new things; so, I guess if I wasn’t a practice manger, I’d be a professor.
Q. The practice manager role is forever evolving. If you could choose your dream team, what would it look like?
I really enjoy people who are always looking ahead. I like people who are not afraid to try new things but equally not afraid of acknowledging when they’ve got it wrong. I strongly believe in empowering people and my ideal team would be a group with a ‘can do’ attitude.