Managing upwards, outwards, and downwards
by Tracy Dell
22 November 2019
Developing skills to manage primary care at scale
It is an understatement to say that the practice manager role is a varied one. We are technically general managers in a primary care setting with a plethora of responsibility. I regularly say that I manage full circle; upwards, outwards and downwards. With overall responsibility for financial management, HR, patient services, staff development, premise management, IT, contracting and procurement, some days it feels like I am doing all I can do keep the practice running.
There are two immediate challenges facing my practice:
- The first is our patients and services. We are based in an area of extreme deprivation with high prevalence in most of our chronic disease categories. We struggle getting patients to engage with us with everything from smoking cessation to medication reviews. Our key clinical issues are mental health, safeguarding, child protection and domestic abuse.
- Our second challenge is reacting and adapting to the pace of change within primary care. Often it feels like we are spinning plates and soon they are going to start dropping. One retirement, or long-term sick leave within the workforce has the potential to push us into dangerous territory.
What triggered me to develop my skills?
In recent years, the most obvious change within primary care - and subsequently the reason I chose to study the Diploma in Advanced Primary Care Management - is the scale of collaboration we are working to. Practices are now required to work together within primary care networks, instead of in silo. In Calderdale we have 25 general practices; this means that 25 practice managers are probably doing 25 things, 25 times. The introduction of primary care networks mean we are starting to move into a more conducive way of working.
Each practice is very unique, with a different variation in population health. However, most practice managers are doing the same thing, just at different scales depending on the size or of their organisation or how it is structured. Aligning working processes and management styles to deliver a consistent service across all practices makes sense considering we're delivering the same contracts. This new territory we are moving into means that we need to be equipped with additional skills. I saw the diploma as the opportunity to learn these skills and develop and implement alternative management approaches whilst expanding my knowledge.
How the Diploma in Advanced Primary Care Management has helped me in the workplace
The diploma encouraged me to think and work differently in the manager role both operationally and strategically. Almost daily I now apply the tools, techniques and knowledge I learnt to my role. The reflective journal that we were required to complete as part of the course was so helpful, getting you to reflect on your day to day processes and plan time better.
Practice managers put themselves last a lot of the time in terms of our educational needs. There is almost negativity around the idea of studying as we are already so busy with such little time to spare. Whilst there are no regulatory requirements to possess a qualification, as leaders in our practices, we should be leading by example. We should welcome the opportunity to undertake accredited study that validates what we do daily and progress the development of the practice and ourselves.
Top tips to anyone studying the diploma:
- Attend the initial taster day – this is the only opportunity you may have to meet everyone face to face
- Engage a WhatsApp group with your fellow learners to support each other with assignments
- Negotiate learning time with your employer but be realistic about studying at home
- Have an overview of the modules and start to think about the projects before your assignments.
- Use examples of something you're working/worked on when writing assignments
- Plan your approach and timings on submission day.
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