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by Valeria Fiore
25 October 2018

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The PM edit: Luan Stewart in her 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 Luan Stewart, practice business manager at Adelaide Street Family Practice in Blackpool 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 have worked for the NHS for ten years and there have been so many changes. Everything has become about working together as neighbourhoods or as a result of mergers.
Although it sounds great, it can be hard for small business owners like GPs to suddenly become part of a bigger group. I have worked under three CCGs and in a few practices, including ones in trouble, to get them through hard times.  
Work has become more interesting, with the introduction of new technologies that have changed the face of general practice. We now speak to patients via text, social media and websites as well as face-to-face; it’s an ever changing workplace.  
Q. When did you begin as a practice manager and how did you get into the role?
I had worked in the airline business for 17 years. When I decided to ‘hang up my flight wings’ I sort of fell into working for a GP surgery – while I decided what the next step in my career should be. I soon became assistant manager and then practice manager in 2014.
Once I started it became hard to leave as I love the daily challenges and variety it has to offer.
Q. What are the biggest challenges of being a practice manager today?
There are so many things going on at the same time. I am running a practice across two sites, and I also manage a pharmacy while organising a new build and working through a practice merger.
Some days I’m not sure if I’m a practice business manager, a building project manager, an agony aunt when staff are having a bad day or a policeman when some patients shout. There is never a dull moment, you need to be very resilient.
It’s a fairly isolated profession as you are in the middle of staff and partners, trying to make everything work for all of them.
Q. What do practice managers need most in terms of support and resources?
Every practice is different and needs different things. However, one thing we all have in common is the need for peer support.
In Blackpool, we have a WhatsApp group for practice managers and we have peer group meetings. This means we have started to look after each other and share ideas and advice. It’s been great.
I have also become a peer mentor practice manager – part of a North West LMC pilot scheme. This means that I meet with a practice manager on a one-to-one level and work with them through a peer appraisal.
The reviewees often use this as an opportunity to talk and ask questions. It is a great source of help for new practice managers who may feel isolated at first.
Q. What do you find most rewarding about being a practice manager?
Seeing projects work, from start to finish. Small ones – such as improving a QOF score, completing an enhanced service, or increasing finances. 
Ask me again when the pile of drawings and meetings of the last few months have become a new medical centre, as I imagine that will be the most rewarding feeling.
Q. How do you see the future of practice management?
I think we will become more specialised. Gone are the days when the longest serving receptionist just stepped into the role. It is now much more business orientated.
Q. What do you think you would be doing today if you were not a practice manager?
I would be in the travel industry, perhaps. Or some form of teaching mature students. I have guest lectured as part of a practice manager course on financial planning and action planning. I really enjoyed that and could happily have taught and mentored subjects that I enjoy.
Q. The practice manager role is forever evolving. If you could choose your dream team, what would it look like?
I work at a very innovative practice, with fabulous forward-thinking partners – so we already have a diverse team. We have paramedics, physician associates, and pharmacists.
If I could add in mental health professionals working directly in the practice and some health and wellbeing drop-in clinics to help patients with social issues, that would be perfect.
Our patient list size is ever-growing, therefore I would like to see a business manager (myself) working with an operations manager to sort out the day to day HR and staffing issues.
Ideally, we would also have a communications lead to take care of the new innovative things we recently introduced – such as virtual PPGs and skype-style appointments.  
The sky’s the limit really.
Luan Stewart is practice business manager at Adelaide Street Family Practice in Blackpool