Management Adviser, Trainer and Facilitator
Patricia is an HR specialist in general practice. She managed a large practice for more than 10 years, and now provides HR and management advice and training. She is also a trained facilitator and a coach
No manager can do everything; nor should they be expected to. Sadly, however, many managers try hard to do it all, believing it to be their duty to take control and manage everything in the practice. Yet delegation is essential to ensure that every member of staff is performing well and is properly supported, that the workload is managed effectively and systems work efficiently, allowing time and space for developing business opportunities and networking.
There are three distinct levels involved in managing an organisation: operational, managerial and strategic.
This deals with the administration and day-to-day running of the practice and includes:
- Supervision of staff.
- Appointments and other systems.
- Dealing with IT problems (such as printers not working, etc).
- Producing audits and searches.
- Managing workflows (such as scanning letters and sending off referrals).
- Paying for items out of petty cash and sending out invoices.
- Checking claims.
- Organising the premises (such as allocating rooms and managing the waiting room).
Of course, this is not an exhaustive list, but managers will no doubt be familiar with tasks that fall into this category. The operational level can involve some ‘crisis management’ – for example, a shortage of staff or sorting out a patient complaint – which means that everything has to be dropped to sort out ad hoc problems. Much of the operational management involves frontline staff and being acutely aware of what is happening at any one time.
The managerial level oversees the administration of the practice, ensuring it is running effectively. It also involves managing resources and staff, as well as premises, IT systems, finances, patient services and partnership issues.
This level of management requires a good analysis of resources, an assessment of issues, information-gathering, data analysis and problem-solving, creating an action plan and making sure that action is delivered – whether by the manager or other staff. The manager needs to be aware of what is happening in the practice and occasionally ‘walk the floor’, but they do not need to be in the thick of it as operational issues can be a distraction. At this level, the manager needs their own space and time to work on tasks and problems, to run meetings and to communicate and engage with others.
The strategic level of managing the practice involves taking an overview of everything, including the operational and managerial levels. Strategy involves planning the direction of the practice and managing organisational changes. It includes the planning of:
- Future premises requirements.
- Future HR resources.
- Significant changes to practice systems, for example, the IT system.
Strategic management also involves seeking out new opportunities to develop the business, assessing the cost-benefits of new initiatives, participating in forums such as commissioning and locality groups, and keeping the profile of the practice high.
At this level, the manager needs to step back from the operational and day-to-day management to assess the bigger picture, while not being so far removed that there is a lack of understanding of what is going on.
With this in mind, practice managers should think carefully about how they spend their working hours. If you are not sure, it is helpful to spend a week or so identifying how each hour of the day is spent and marking them with an ‘O’, ‘M’ or an ‘S’, denoting each of the above areas. It is far too easy to get bogged down with the operational running of the practice. If this happens, the manager will not have the time or energy to spend on management and strategy.
I know many practice managers clearly challenged by how they spend their time. A number of them are aware that much of their work is spent in the operational area and realise it is not a good use of their skills and time. They say things like:
- ”There is no one else who could do this part of the job.”
- ”No one wants to do it.”
- ”Other staff don’t have the time, they are all busy in their own jobs.”
- ”I am the only one who understands it properly.”
- ”I have handed this over before but it got in a mess and bounced back to me.”
- ”I need to do this, otherwise I don’t know what’s going on.”
- ”I know what works because I have been around the longest.”
My response to these, and many similar, comments is to advise them to consider what is happening and the impact this has on themselves and others.
Principles of delegation
Delegation does not come easily to some; good delegation has as much to do with the delegator’s own confidence as their trust in others. It involves a clear vision of what needs to be achieved, identifying the right person or group to be delegated to, excellent communication and negotiation skills, enthusiasm to encourage others, perception as to how they are getting on, and openness to new ideas.
Delegation is about allowing others to take the authority for a task, while the delegator remains ultimately responsible. Otherwise it can feel like dumping rather than delegating. When it works well, delegation becomes a learning process for the whole team and is extremely motivating.
However, the manager has to learn to let go – and many managers struggle with this. It is important to keep focused on the benefits, not only to the manager (such as releasing time and energy for higher-level activities) but also for the person being delegated to (such as allowing them to develop and learn new skills). There are also benefits to the organisation in developing a learning and blame-free culture that encourages people to have a go.
So, what are the principles of good delegation? First, the area of responsibility needs to be identified, fully discussed and a way forward agreed, resulting in a clear definition of what is being handed over. The person being delegated to should be involved in these discussions.
Next, it is essential to ensure that the person taking on the task has the training, skills and potential to undertake the job, or at least is able to learn the skills by being supported in the role. They must also have the time to perform the task. They might achieve this by delegating less complex duties to another employee.
In this way, everyone should be performing tasks to their own personal level of ability and feel comfortably stretched in their job. You may worry that a member of staff will not have the capacity to take on a new role, but it is often surprising what people can fit into their working hours if they feel challenged and interested in what they are doing.
Selecting the right person to be delegated to is obviously crucial to success. This is where communication, encouragement and negotiation skills come into play. Does the employee want to take on the task? Do they think they could do it? Some people have limited confidence in their own abilities, but you may see potential or even existing skills that are not being used to the full. At this stage, you need to stay upbeat, encouraging and positive. If you truly believe in them, they will believe in themselves.
You will also need to communicate the changes to the practice team, as well as the reason why the delegation is important. Encourage the team’s feedback and ask for their co-operation in what is going to happen. This will give the person being delegated to the best chance of support from their peer group and ensure that everyone understands the change.
The next step is to explain the task to the individual and clarify what is involved. Show how you do it, give examples, share experiences and admit to your mistakes. Provide any hands-on training or information that will help them to understand and perform the task better, but avoid overwhelming them before they have got started.
Hand over the task when the person is ready and keep an eye on them from a distance, while being available for questions and support. Be prepared that the person may carry out the task in a different or even better way than you. If they do, that is great because you have both learned something.
Don’t forget to review and monitor progress, more frequently at first but with a ‘light touch’ once the person’s confidence and ability increases. Provide plenty of encouragement and praise, as well as constructive feedback. Seek feedback from them too: are they enjoying the task? What difficulties have they experienced and how did they deal with them? Is there another task they would like to take on?
One school of thought, to which I subscribe, encourages all individuals in an organisation to do things their own way (within reason of course), playing to everyone’s strengths rather than focusing on their weaknesses. With this ethos in mind, delegation becomes a natural process. It involves agreeing upon the desired outcome only and allowing an individual to find their own way of achieving the job, but with plenty of encouragement. It sounds a bit scary because it really does mean letting go, but if you have the courage I am sure you will be won over by the results.