WHAT IS A PRACTICE MANAGER?
Linda Turner VTS Scheme 11th June 2008
Practice managers come in:
– all shapes and sizes – all cultures
– both sexes, etc
They are not usually “practising” to be a manager They are usually a “jack of all trades” Often “pig in the middle”
Their role can be varied and depends on many things:
– the type of practice they work in – the size of the practice – the attitude of the GP – their experience – their qualifications
HISTORY OF PRACTICE MANAGEMENT
Practice managers have been in existence for around 40 years Originally little more than a senior receptionist Occasionally an administrator
1990 CONTRACT
– Brought about increased responsibilities and a greater need for a “manager”
Fundholding
– Practices became small businesses – Practice managers became business managers
New Contract 2004
– Even greater demands on practice management
Competency framework for Practice Management was introduced as a guide to the role of the practice manager
RESPONSIBILITIES
WHAT ARE THE MAIN RESPONSIBILITIES OF A PRACTICE MANAGER?
COMPETENCY FRAMEWORK
9 MAIN AREAS
GENERAL RESPONSIBILITIES
Will depend on size and type of practice but will generally include all or at least some of the following.
Practice Operation & Development
Primary Health Care Team Meetings Development Plans / Reports Clinical Services Care Pathways Liaison with secondary / tertiary care providers Strategy formulation Innovation Clinical audit Organisational audit Clinical effectiveness and evidence based practice Resource allocation Professional development Research
Risk Management
Health & Safety Fire Safety Risk Assessment Significant event audit / reporting Infection control Confidentiality Ethics Occupational health Poor performance Disaster planning
Partnership issues
GP time management Locums Partnership meetings Partnership agreement Partnership changes Taxation CPD requirements
Patient and Community Services
Reception Information Clinics / health promotion Complaints Community Liaison Patient protection Community Nursing Social Services Working Partnership Networking with colleagues from other practices
Finance
Petty cash Payroll and pensions Invoice payment Insurance Monthly accounting Annual accounts Claims/targets/quality payments Drawings Quarterly statements Bank and accountant Cash flow / budgets Staff funding Planning information Service budgets Deficiency register Resource negotiation
Human Resources
Staff management Staff meetings Rotas and work Recruitment and selection Induction and training Employment practice Disciplinary and grievance Performance review Pastoral care
Premises and Equipment
Supplies Equipment Facilities management and maintenance Facilities provision Security Project management (equipment/premises)
IM&T
Patient records Data management Data security Data interpretation/manipulation Hardware maintenance GP links Crisis management Project management
Population Care
Health needs assessment Service performance indicators Strategic delivery planning Service prioritisation Resource negotiation
Competency Framework
Considered to be 3 types of manager:
– Administrative – Managerial – Strategic
Clinical Audit
Administrator
– Provides data for audit and may participate in planning audit and organisation of data
Manager
– Will co-ordinate process directed by clinical governance lead and may collaborate on clinical governance, review and disseminate audit results
Strategist
– Leads the audit process, taking responsibility for cycle completion – May advise others on audit structure / format
Health & Safety
– Administrator
Is aware of policy/operates procedures. May ensure basic systems are in place
– Manager
Develops H&SW policy, ensures compliance with statutory requirements May also develop or implement effective policy and lead on H&SW
– Strategist
Will develop / implement effective policy, leading on H&SW issues May also advise on appropriate policy and procedures
Partnership Changes
– Administrator
No involvement
– Manager
Co-ordinates arrangements for the changes May be involved in organising finances and liaison with external bodies
– Strategist
Will lead recruitment process, participating in interview and selection, and advising on potential problems May also co-ordinate process and advise on statutory requirements and partnership options
Reception
– Administrator
Will supervise staff, and take responsibility for their work plans and may co-ordinate reception services
– Manager
Manages all staff and services. May be involved in evaluation/ensuring service complies with best practice guidance and standards
– Strategist
May advise on structure, resourcing, extended services and training needs, ensuring appropriate availability of training
Drawings
– Administrator – Manager
No involvement
Calculates and arranges payment under supervision. May undertake without supervision in accordance with partnership agreement
– Strategist
Will seek independent advice and provide drawings forecast. May also facilitate independent advise on drawings management
Employment Practice
– Administrator
Has awareness of importance May have limited involvement in monitoring policies against practice/external guidelines
– Manager
Will have detailed, current knowledge of employment legislation and record keeping requirements May also ensure practice policies / procedures comply with statutory requirements
– Strategist
Undertakes anticipatory action to ensure practice policies/procedures will conform to changing statutory requirements May also advise on implementing good employment practice
Equipment
– Administrator
Monitors equipment and reports problems. May monitor maintenance schedules
– Manager
Will organise maintenance schedules and recommend new purchases May plan long-term replacement of major items, recommending purchase or lease
– Strategist
May advise on purchase / lease options and maintenance requirements
Crisis Management
– Administrator
Reports problems as they occur May be responsible for identifying potential problems
– Manager
Undertakes problem solving and leads crisis resolution May lead on anticipatory crisis prevention
– Strategist
Undertakes disaster planning to ensure system and data recovery with minimal loss of service May advise on crisis prevention/recovery and assess effectiveness of system safety / security
Health Needs Assessment
– Administrator
Provides data to support assessment process May collate data in readiness for analysis
– Manager
Will co-ordinate assessment process in collaboration with clinicians. May initiate assessment and manage multi-disciplinary process
– Strategist
Monitors demographic changes in conjunction with service provision review, recommending changes as appropriate May implement programmes of anticipatory care in conjunction with clinicians
WHAT DO YOU THINK MAKES A GOOD MANAGER?
What makes a good manager?
Good HR skills Some knowledge of employment law Ability to multitask Innovative Motivated Good financial controls Good in a crisis Ability to think through problems Ability to follow through with ideas Good communicator Health Service experience – preferably general practice Managerial experience Educated to a good standard
The Future of Practice Management
Associates of Practice with a % share of profits Fixed Share Partners Equity Partners APMS Practice Leads – employing GPs and nurses to run the surgeries whilst having overall control
REMEMBER
BE NICE TO YOUR PRACTICE MANAGER SHE KNOWS MORE THAN YOU THINK SHE COULD ONE DAY BE YOUR BOSS!