The role of the practice manager has changed significantly since I first started and changes from day to day, that is why having good networks as resources are so important today
The practice manager of today has seen the implementation of so many new processes over the last few years which has included the implementation of CQRS which for many has been a frustrating programme to use. The process for claiming our income, there seems to be two or three ways to claim now which used to be one. The changes to QoF every year and what is staying, what is going and what is staying but with changes. Also the enhanced services that now are called primary care quality standards. How can we keep u, you just get used to it and then it changes. The dreaded CQC visits and what is expected at them and what hoops you have to jump through. The list is endless of the changes that practice managers have to keep up with on a day to day basis.
CQC visits to many practice have left them feeling demoralised, devalued and completely fed up with the whole system. We have now have two full visits and one focused visit and we have now been marked as good which was a relief to everyone involved with the practice, from the staff to the partners and to our patient participation group. I can honestly say that if we had not received a good from our last focused visit then I was seriously considering leaving general practice. I know there a lot of other managers out there feeling the same way. I meet with managers both locally and nationally and the feeling seems to be the same countrywide.
Once we seem to get our head around all the changes then they throw more at us. I am afraid I feel that the future for general practice is grim. Practices are facing workforce shortages, trying to engage a new partner to a practice is very depressing as General Practice is not looking attractive for new GPs.
Another pressure facing practices is the reduction in funding and the ever increasing costs. More staff are needed to deliver the services and the costs are sometimes more to practices than they are receiving, so practices need to consider carefully what they are going to offer to patients . For example in my practice we will now have to consider whether we offer the NHS health checks because the funding that we will receive for this has now halved.
What does the future hold? The new GP Five year Forward View which apparently is the answer to the crisis in General Practice. Don’t get me wrong I do think that there is some excellent stuff in there if it is delivered. I have been shouting at every meeting to say we need more training for practice managers and front line staff. More bespoke training for all practice staff. The receptionists, in my opinion, do one of the hardest jobs in general practice. They get it from all sides, patients, doctors, nurses and me. We offer them no extra training or support to do this job. It is very stressful and often for very little pay. So this is something that they are meant to be investing in, so if they deliver this as they say they will I know it will be appreciated in most practices. Extra training and support for practice managers, again a must. Practice Managers do a very lonely and difficult job. How many other industries do the managers manage the people that employ them.
The future for GPs working in their own surgery and seeing their own patients will be a thing of the past. Practices will have to work together to survive. Patients in the future may have to go to a hub to see a GP, the personal service will be a thing of the past. A lot of practices are already part of a network or federation, and if they aren’t yet then they will soon have to be.
Information technology is playing a big part in the view and with the plan for joined up care and everybody that is involved with the patients care being able to view the patients record. The NHS has never got this quite right before so let’s hope they do this time.
I could go on about the forward view all day and in reading it, most of it makes sense, not all. But the resources have to be there first to make it happen and unfortunately I don’t think it is yet but with any luck it will all come together in the end. You have to be optimistic in this job.
Now back to my day job, new receptionist to be interviewed, locums to find, sort out air conditioning, we all know the tasks are endless.
Here is to the next five years!!!