A qualified response to primary care pressure

by Emma Prince

28 November 2019


With the expectation for primary care to work more at scale, I wondered if further studies would support this

At times, the role of a practice manager can be all encompassing and the changes in recent years, coupled with rising patient expectation, have ramped up the intensity levels. To help me meet these challenges I recently studied for the Diploma in Advanced Primary Care Management and this has helped me both in my role at the practice and more broadly across the primary care network.

Whether your practice is big or small, the responsibilities can sometimes seem endless. I work in a pretty small practice, serving a population of about 5,500. In my case, the small size of the practice means more responsibility falling on my shoulders. We don't have a management team, it's mainly me. I have to oversee service delivery, finance, human resources, premises, health and safety, strategic development, claiming and everything else in between.

Alongside my role as Practice Manager, I am also Network Director for our Primary Care Network a day and a half a week. This position transitioned originally from my lead Practice Manager role for the locality into a lead manager role and then finally into the director position.

My practice covers an area that is mostly middle class with a mixed population – we have a lot of young families with children and elderly people living in their own homes who can be quite isolated and vulnerable as they get older.

The wider primary care network we are part of serves a population of about 50,000.  Even though the 4 practices are close in geographical area, we are miles apart in terms of patient needs. One practice, half a mile from us, lies within a more deprived area with many patients having chaotic lifestyles and a large number with drug and alcohol issues.  Another of the PCN's practices has many patients who are care home residents, so arrangements need to be made to treat these people there, which can increase pressure on the practice.

One frustration with communication of the primary care network agenda has been the way it has overlooked the management side of leadership and focused only on clinical directors. My network decided early on that as well as the clinical director focus, we also needed to have managerial input. Therefore, we set up a joint leadership team consisting of me from a managerial side and a GP as the Clinical Director.

In the last 10 years working in a general practice, the intensity and complexity has increased massively. National systems are getting more complicated. The lack of stability around processes can be frustrating. And, as well as this increasing pressure from the top, we are also dealing with an increase in patient expectations. It's almost like the 'amazon effect' has made some people expect everything straight away.

The intensity arises from trying to find new ways of working. To help with this, I decided to study the Diploma in Advanced Primary Care Management. This qualification stood out as one of the few qualification relating specifically to primary care.

The diploma was a lot more theoretical than I had first assumed.  It was extremely interesting, but not in the ways I had originally expected. The NHS policy, law and governance module was eye-opening, and I learnt so much. Our tutor really bought the topic to life and I loved how he summarised and shared learner feedback from the discussion board, giving us the opportunity to learn from one another and not just him. I also found that the Leadership module consolidated lots of leadership training I had done in the past and was helpful in my role as PCN director. 

My first recommendation for anyone considering studying the diploma is to be realistic. The course is very honest about the amount of reading that is required during each week. I went into it thinking this couldn't possibly be true, but it is. You need to think how it will work for you and be realistic about what you can commit to. If possible, negotiate with your employer to have learning time during working hours. I found the fact I work 4 days a week a life-saver!

My second recommendation is to use your group of peer learners – they are invaluable to you. I struggled with the learning not being face-to-face, but we set up a WhatsApp group to bounce ideas off one another and ask questions. This kept us all sane while doing the assignments! 

Please click here to find out more about the diploma in advanced primary care.

To speak to a member of the team call 0117 938 8351 or email us.

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