1. GP Practice Management The Role of a busy Practice Manager

2. 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

3. 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

4. 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…

5. 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

6. 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

7. 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)

8. 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

9. 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

10. 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