Before becoming a practice manager, Ruth was senior manager for 12 years at Bradford Royal Infirmary, and also worked for 12 months in the voluntary sector. A keen runner, having done the London Marathon on a few occasions, Ruth also spends her spare time watching her son play rugby and taking her daughter swimming
I arrived in Leeds in July 2003 to take on a new position in practice management, having been a practice manager in Bradford. I was expecting the same dreary and dreadful forums to attend each month, which basically never achieved anything more than being offered the usual plastic sandwich and sugar-filled “fresh orange”!
Well, how pleasing and surprising it was to find the opposite: a core group of managers who actually discussed relevant issues, were supportive and welcoming – and provided sandwiches to die for!
The original forum was chaired and run by the PCT. They made the decisions and dictated who should attend the meetings, which subjects should be discussed and what presentations there should be.
After about a year it was becoming increasingly frustrating for us as managers to find that, more and more, the PCT seemed to be taking the lead and there seemed to be no time available to discuss relevant practice issues. It was all about the PCT, their objectives and what they felt were relevant to us as managers.
In April 2004, after one particularly long-winded “presentation”-filled meeting, which was of no relevance whatsoever to us as managers, we decided to rebel. We made the decision to contact the PCT and inform them of our frustration at the lack of vision, clarity and relevance of the meetings. We sent a letter on behalf of us all to the director of nursing and health care development at the PCT. Following this letter, representatives from the PCT agreed to meet with us to discuss the way forward for future meetings and with a view that an amicable agreement could be reached.
Agreements on future meetings of the Practice Managers Forum were reached in May 2004. These included:
- Venues to have adequate space to accommodate future meetings.
- Drug representatives not to attend.
- PCT to provide lunch.
- Chairing of the meetings to be undertaken at six-month intervals by the respective healthcare development manager (HCDM).
- A nominated practice manager to be identified to work with the HCDM to agree the agenda.
- The agenda, wherever possible, to reflect 50% PCT and 50% practice management business.
- Speakers to attend only if agreed by chair and practice manager, with the purpose and need for attendance clear.
- The chair to ensure adequate information is provided on agenda items, which would enable discussion and decision-making to take place.
- A monthly practice manager newsletter to be produced to aid effective communication.
- The first hour of the meeting to be with the PCT; the second hour to be kept free for practice managers only.
The meetings were reviewed six months later in November 2004; both managers and the PCT agreed that these were working well and that the format should continue.
So, what did the new format achieve that the old format couldn’t achieve?
The current forum consists of 15 practice managers, all of whom attend all or most of the meetings. There are managers with specific areas of expertise (eg, IT, law, HR), who will liaise with the PCT on these issues on behalf of the group. Due to the relevance of the agenda, speakers and items for discussion, attendance at the meetings has increased. Better working relationships have also developed and been formed with the PCT.
Our nominated practice manager has a wealth of experience and is manager of the largest practice in Leeds West. She is very proactive on our behalf and will make decisions about whether items put forward for discussion are of relevance to the group.
The following are just a few examples of what has been achieved under the new format and working collectively as managers:
- Phlebotomy – increasing problems were noted with the phlebotomy service provided by the PCT. Staff wouldn’t turn up at very short notice, there were training issues, etc. As a result of the forum, managers were asked to be involved in the commissioning process when the new contract was up for renewal earlier this year. Practices were given the option to provide the service themselves or, if they wanted to remain with the current service, to receive compensation if the phlebotomist didn’t turn up.
- IT – major problems were identified with IT and the maintenance contract. We have been instrumental as managers in influencing the PCT to look at the maintenance contract and its inequalities. Resulting achievements include not having to wait a week or more for prescription printers to be repaired; spare equipment being kept at the PCT to be used by practices in emergency situations; worksheets devised for use by the engineers to ensure all work specified is carried out and that the allocated time for site visits is spent at the practice.
- Introduction of quarterly meetings with the PCT directors to raise any concerns or issues we have.
- We are currently in the process of negotiating with the PCT to run the training budget for “target” sessions, looking at organising relevant training issues for staff throughout practices in Leeds West, with a view that this is done a year in advance.
I am sure I speak for all in our forum in saying we all feel privileged and proud to be involved in such an innovative, supportive and forward-thinking forum where the primary focus is to improve the day-to-day running of practices and improve the quality of care provided to patients.