GP Practice ManagementThe Role of a busyPractice Manager

Key elements of the Role No two days are the same Role has evolved over the last 10 years+ Less involvement with patients and public Dealing with complaints, significant

events and clinical incident reporting Duty to reduce paper use – more IT Hire and manage reception/admin team Payroll and/or practice finances

Extent of HR duties More involved in GP/clinical team

recruitment and day to day team support Regular meetings with other PM’s and CCG

members – keep up with changes New ‘fund-holding’ opportunities – consider

needs of patients/priorities Supporting Nurse Practitioners and Clinical

Pharmacist in roles – save Practice £’s+ Filling in when non-clinical team sick/on

leave

Financial responsibility Payroll: may outsource work Reporting/claiming for work done: LES,

DES, capitation, holiday imms, rent Prescribing budget: involvement in

campaigns to reduce prescribing of costly drugs when cheaper generic alternative

Temporary patients: short/longer term Private reporting: for employers, insurance QOF: quality and outcomes framework…

Quality and Outcomes Framework (QOF) Hierarchical system of recording data: four domains

are Clinical, Public Health, Quality and Productivity and Patient Experience

Easy way to monitor correct and full compliance with agreed ‘best practice’ - added indicators each year

Entry on chronic disease register opens up requirements to provide associated therapies, reviews, tests, supporting data

Cross-recording of data between disease registers: acts as alert to possible other ailments or contra-indications in therapies

Payment to practices based on number of points achieved: points make prizes: £156 each point

Annual projects & campaigns Flu vaccination Pneumonia vaccination HPV (newer) MMR and other child immunisations Chronic Disease annual reviews Medication: annual review (minimum) QOF: various elements inc. policy

updates, patient input, surveys, access and Carers Register

How can Practices support Carers? Data protection: Who are the carers? What if they are already

patients? GP doesn’t have time Who is responsible? How do we start/prioritise

updating records? Which register first? How do we code

correctly?

Cared for gives permission Ask them at registration Add question to ‘yellow flag’

or add to all mail-outs Invest a little; gain a lot Build into practice systems Chronic disease registers:

most sick will have support Palliative care, then multi-

CDR Give them Read codes

(same in all practices in UK)

Barriers to communication Receptionist is ‘frosty’: Why?...

Is not well-paid position for level of responsibility – making decisions about who gets the appointments, if prescriptions are really urgent, dealing with conflict daily – can be stressful

Hassle from patients all day – sick people can be more difficult than well ones, phone doesn’t stop ringing, worried parents insisting on being seen urgently

Defensive attitude because of people (other than you) trying to get past them to sell products and services to the GP’s – more now because of commissioning role

Limited resources – appointments, time, prescriptions needing signature at end of surgeries by busy GPs

Some ideas to help at first Wait quietly when you come in until queue clears – let patients go in

front of you to check in – show empathy, smile Realise that receptionist would rather deal with an easy enquiry –

keep it simple Don’t wear a suit – smart casual is best – don’t wear jeans unless

very smart ‘Sorry to bother you’; ‘busy day?’; ‘I know you are busy’; ‘would you

mind if I take a couple of minutes of your time?’ Eye contact Ask direct questions but don’t ask for their help or imply that you

need them to do anything for you – they are busy enough ‘Would I be able to speak with the Practice Manager for a few minutes

or leave a message with you?’ Introduce yourself - keep it brief. ‘I can wait’ – don’t seem rushed. ‘I am hoping to talk to your team about carers and we have some new tools that will help identifying them much easier and less time-consuming’

Don’t just leave leaflets – people do this all the time – they will probably go in the bin

More handy hints Avoid dropping in:

Before 9.30am (morning madness) Noon/lunchtime (most likely closed, busy in run-up to lunch) 2pm/re-opening time (patients calling for results) 5.30pm plus (GP signing prescriptions, letters, visits to do)

Best time to call is between 3.30 and 5.15pm: may catch GP – bit quieter

Have information with you to leave at the practice, but place in an envelope addressed ‘Private’ to the Practice Manager

Keep information simple and direct – don’t appear to be selling anything or asking for any help – just sell the benefits of having your free support and how that will save their time and make their job easier