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Tuesday 16 January 2018
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In conversation with... Gareth Williams

Sometimes, when there are no GPs available to hire, a practice manager should be ready to take the risk and think creatively

Gareth Williams works as practice manager in Park Avenue Medical Centre in Northampton, which has around 10,074 patients

Q: You were rated ‘good’ by the CQC. How do you keep your practice thriving?

A: We have regular clinical meetings and try to involve, maintain and train the staff. I am not happy for my staff to come in and say ‘I am just a receptionist’. I want you to be the best receptionist.

We have an ethos of being a family friendly GP practice. We concentrated on that and when we did the recent refurbishments, we put low lights and some background music in the waiting room to calm people.

Q: How important is technology in your practice?

A: Very important. It is as important in terms of efficiency as training my Heath Care Assistants (HCAs) to do their job effectively. Sometimes people don’t see how technology makes things more efficient. Technology has revolutionised the care of patients in primary care and if secondary care could link into our technology, the quality of patient care would be hugely enhanced.

Q: Why is it important for you to train your HCAs effectively?

A: We see HCAs as an essential tool in the management of patient’s conditions. They are high skilled individuals who don’t need to make clinical judgements. They will do bloods, ECGs, collect data and triage the patients to the next appropriate tier, and see my diabetic patients. They will take the bloods and my nurse will only see them if the patient’s diabetes is out of control.

This goes for COPD and asthma hypertension and all the other long term chronic diseases we deal with. Good news is they are half the cost of a nurse.

Q: Have you seen a reduction in expenses by hiring more HCAs?

A: No, what we have seen is an increase in capacity. The benefit is that my diabetic nurse now has time to spend with patients. Instead of having to rush through a patient in ten minutes, she has time to see patients whose diabetes is out of control or a patient newly diagnosed with diabetes for 30 or 40 minutes.

Q: Why have you adopted this system?

A: We have been forced into it. We don’t have enough money for people to be able to see GPs for things like verrucae, sore throats and blocked ears. People say ‘I can’t recruit a doctor’, and I answer that we have to ‘look at this creatively’. Instead, I can have two advanced nurse practitioners for the cost of a doctor, for that I get extra capacity because doctors can spend more time with patients to do high level diagnoses.

Q: What is the biggest problem you are facing at the moment?

A: Our biggest challenge will be educating people who are ‘well’ and keeping them well. We are swamped by demand and it grows year on year, so we need to think about how to educate patients to understand the impact of healthy eating, manage their own mental health and lower their expectations that a doctor will be able to cure them no matter what. Instead, we want to bring people together, to have them to run clubs in the surgery.

Q: Do you manage to keep a close relationship with your patients even though most of the stuff that you do is ‘behind the scenes’?

A: I try to keep as close as I can to my patients. For example, I pick the phone up for 20 mins in the morning during peak times and deal with patients’ issues. I think that it is the interaction with the staff and patients that makes this job worthwhile.

Q: What would you say is your biggest achievement as a practice manager?

A: I would say there are two considerable achievements. First, I was able to maintain patient care while reducing the number of GPs and taking a risk hiring advanced nurse practitioners. The second is having invested £250m to refurbish the practice. The place looks smart and patients are happy with the way it looks.