The Road to Practice Management, and beyond

A practice manager working in primary care

Guest blog by Nicky Billington, Practice Manager at Wells City Practice and South West Regional Representative for the Institute of General Practice Management

When I started work in primary care, as a prescription clerk, I had never heard of a practice manager. I knew about GPs, nurses and receptionists but had no idea about the amazing team of people behind the scenes.

A few years later, with a bit more experience under my belt, I did an AMSPAR/ILM Course in Primary Care Management. I had huge gaps in my knowledge, but I knew that this was what I wanted. Passing the course gave me the confidence to take the next step, and I applied for the PM’s role at Wells City Practice.

BEST DECISION EVER! The Mendip PMs group welcomed me warmly and never judged me for those “stupid” questions. During my first few weeks I was invited down to the LMC office in Taunton and met with Jill who gave me some really good advice and information about General Practice in Somerset. I was amazed at how active and involved the LMC is in our everyday work life, they are my first port of call for advice on training, governance, and contract issues, or even just a moan.

Wells City Practice

Practice Management can be a lonely job, but it is also challenging and extremely rewarding. You are at the top of the tree, with everyone looking at you for answers, help, direction and often a shoulder to cry on. The job is amazing, and endless. My day can start with unblocking toilets and fixing door handles, and end with covering reception as they are short staffed. In the middle I am managing budgets, recruiting staff, haggling for discounts from suppliers, managing refurbishment of different areas of the practice and counselling tearful staff who are fed up of the abuse they get from disgruntled patients. The workload is totally unmanageable, and each day is spent firefighting.

About 18 months ago I became a representative for the Institute of General Practice Managers, covering the Southwest of England, personally responsible for Somerset and Wiltshire. This may seem like an odd thing to do, considering my comments about workload, but I chose to do this, in my own time, as a way of offering support to other practice managers. The IGPM’s most recent achievement is the launch of the Accreditation Framework which gives all managers with more than two years’ experience in practice management the opportunity to become formally accredited and obtain professional status. This is not an easy process, the application requires a lot of information, evidence and references over 10 domains. There is a one-off fee of £280 and applications can be submitted for assessment during January, May and September. Successful candidates will receive a certificate and an e-signature including the letters MIGPM. Somerset ICB has offered to pay for the accreditation of one Practice Manager from every practice in Somerset. IGPM – Institute of General Practice Management.

The Mendip Practice Managers group has always been strong and supportive, and this only increased with the introduction of the Primary Care Networks. Although it meant the larger group of 12 practices was split into 3, we still meet as a whole group every month, usually joined by either Jill or Mandy to update us on LMC news and help with anything with are struggling with. The PCN has increased the workload for practice managers but the extra services we can now provide are amazing. We have a fabulous team of Health Connectors, Care Coordinators, Pharmacists, Phlebotomists etc, and we can now provide First Contact Physiotherapy and Occupational Therapy for our patients.

The career path for a practice manager is not an obvious one, people seem to either progress through a Primary Care career or move across from industries such as education, local government and armed forces. We even have one IGPM Representative who used to be a solicitor. Nobody heads to university with lofty plans to manage a GP practice and I would love to see this become the case one day. It is not an easy job, by any stretch of the imagination, but it is varied, challenging and incredibly satisfying. It is also hugely important, the IGPM have published various quotes from notable people such as:

Dr Krishna Kasaraneni GPC – “We couldn’t do half a day’s work without our Practice Manager”

Dr Nav Chana MBE – “Great general practice relies on excellent practice management led by Practice Managers”

Dr Minesh Patel, Chair of the National Association of Primary Care – “Great Practice Managers lie at the heart of every great practice”

I am immensely proud to be a Practice Manager but know that I could not do this job without the support of others such as the Mendip PMs, Somerset LMC and the IGPM.

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