We heard in our last article about our anonymous returning Practice Manger's first week back in GP land. In this second part, she answers questions about the journey she has been on (and is still making!) and offers her hints and tips for staying sane.

My Success Story

An incident that happened with the GP’s concerning my request for a review after week one. 

It didn’t happen till week two, when I got a message stating lets do that review.  All the partners came to see me, a little bit of doubt crept in, but it was a positive experience.

I asked is there anything I am doing that you don’t like or is there something I should be doing, that I am not doing presently?

Their reply was really encouraging, and I felt valued, they turned the question and asked, is there anything we are doing that you don’t like and would like us to do differently.

Q. How would you sum up the practice at this early stage - what have you taken into the practice that is invaluable?

I’m already finding my training skills helpful – even though I have never used this clinical system, my knowledge of medical terminology and clinical coding has helped me to help people who are new to their evolving roles. I’ve even been able to impress the doctors by passing a few terminology tips their way!

Q. Is there a particular individual who is making a difference but is up against and would benefit from training?

I’ve got a deputy who has never been in that role before. She’s great – intelligent and enthusiastic but she hasn’t got any management experience. I want to share with her my years of knowledge and also use some of my training experiences to help her to bypass some of the obstacles I encountered throughout my own development journey. I guess though that some of the mistakes and tough calls are part of that personal journey for everyone. We learn in our own way and we have to make mistakes in order to build on what we already know.

Q. What early success stories can you share?

Getting rid of stacks of old accounting and HR paperwork that should have been disposed of years ago helped me to see how the practice has grown over the years. Familiar names start to appear through the documents and systems in place that have evolved into electronic methods of recording and managing information are visible in the paperwork as it moves with the times.

I found almost £300 in petty cash within the paperwork that had been shoved in the back of drawers in the office. That’s got to be a win! Also, one very ‘set in her ways’ admin lady has snapped my hand off when I offered to take the income reporting from her. I think it’s the approach sometimes, especially when you’re talking to staff who are resistant to change.

Q. What one thing would you tell someone who is thinking of going back into GP land?

DON’T!

Joking, it’s great! I think it’s worth being open-minded and ready for a big challenge. Write a lot down.  There’s far too much to trust to memory. Find a system that works and build on it. Talk to other PMs and let them help you – you can’t do this alone. There are some great PMs out there who have got this off to a tee.  Don’t turn down help that is offered to you. Be prepared to change the way you’ve always done things – it’s different now but the same – hard to explain but be open-minded.

The other thing – very important – communicate! With your deputy, your team, the clinicians – everyone.  Include the occasional staff like the ARRS and physios – whatever their role and contracting arrangements, make sure you include them in everything that is going on. I said I would do the appraisals as soon as I started but there’s no way that’s happening yet.  I will do it soon, but I am making time for people who call in to see me – to ask questions, favours, for time off, information – anything! Don’t turn them away or say, ‘I’m too busy’. Make the most of opportunities to talk to those around you – it will help you to grow in your role and to build people’s trust. Thank them from day 1 for all their help and support (even if it’s not that obvious). Take them on the journey with you.

Q. What are the main changes that have been made since you took up your new post.

Clearly, the gradual disappearance of lots of paperwork  Phew! Also, I’m recording everything. We have a lot of information recorded – like meeting notes – but I’m doing a lot more of that  Part of the ‘prove-it’ regime that’s needed in preparation for any CQC visit. I am building up valuable proof and audit trails.

I’ve found that some of the staff have opened up to me and feel they can ask me things. They are, in turn, offering their help and to train and guide others who are struggling in their evolving roles or who are overloaded in terms of workload. The team seems to be gelling a lot more.

We had some clashes – not so much personality clashes, but role clashes and misunderstandings. These prompted open, honest discussions and sharing of experiences and feelings. That helped us, as a team, to move forward. Things are a lot better already. There’s always that anticipation when a new manager or senior staff member comes on board and there will always be mistrust and misdirection.  It’s all coming together now, and I can already say that I’m very proud of my amazing team.

Q. What’s the change that has happened since you were last managing a practice.

PCNs.  All the different roles. Ensuring everyone – even the ARRS roles are fully embedded. That doesn’t just mean that they are invited to meetings. It’s much more than that. Making sure you’re aware of their development needs, communicating effectively with them, knowing them even. It’s easy to lose touch with people and hard to make sure that you include everyone and everything. It’s a challenge however I know how important people are in the NHS – we rely on the brilliant staff around us. We all work hard. We all moan about how busy it is. We all have days where we wonder why we do it. However, we all do it because we love it!  Nothing has changed there. I find myself still working with a group of dedicated and devoted hard working health professionals who wouldn’t have it any other way. We’re a team – strong and resilient.  Working together with limited resources to make sure we give the best to our patients that we possibly can. 

Thornfields Manager and mindfulness expert Charan Sarai is running some Touch Base sessions where Practice Managers can have a confidential chat with her to find a listening ear, get support, and be signposted to useful resources and information. Email her now at charan@firstpracticemanagement.co.uk  to book your session.