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Wednesday 28 September 2016
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Funding pressure far from remote

Comment: Final word

I have the best practice management job in NHSScotland, as National Co-ordinator of the Scottish Practice Management Development Network (SPMDN), funded by NHS Education for Scotland (NES). I have been in post for two-and-a-half years and, as for all practice managers, every day brings new variety and challenges. My job is never dull and is |constantly changing.

Getting out and meeting practice managers 'on the ground' is vital to my role, as I am regularly asked to represent the profession on a range of strategic working and steering groups. To do so effectively, I must be aware of the factors effecting general practice. I depend on the SPMDN local co-ordinators to be my eyes and ears and to keep me updated. They take the lead in organising learning events and network with their local practice management colleagues, passing on information from me to those colleagues.

In November, I was in the Shetland Isles providing a practice management learning event. Practice managers in remote and rural areas find it more difficult to get their development needs met as it is so expensive for them to travel to the central belt, where most training courses are held. So I met with the Shetland local co-ordinator, who took me to visit several practices.

Practice managers across Scotland tell me their greatest challenge is dealing with increased financial pressures caused by a reduction in income.

Surgeries in more rural areas face particular challenges, as many of them are dispensing practices. It is government policy to provide access to community pharmacy services for everyone and, as a consequence, pharmacists are opening businesses in the most rural areas. Most dispensing practices use the supplementary income to fund additional staff and GPs, and are concerned about the practice's future viability. Where practices have lost their dispensing contract, the loss of income has led to a reduction in the number of GPs and services in some areas.

An additional pressure facing Personal Medical Services (PMS) practices is that in some areas Health Boards want to renegotiate their contracts to General Medical Services (GMS) – all presumably to save money.

Every practice has its own challenges to deal with; it is certainly untrue that those in remote and rural practices have a less pressurised life.

On my return from Shetland, I had just one day to finalise my preparations for a two-day training event for cohort seven of the Practice Managers Vocational Training Scheme (VTS). The initial pilot of the VTS included both England and Scotland, and we are fortunate that NES has recurrently funded the VTS.

Leading the VTS is one of the best things about my job. Prior to my present role, I was a trainer on the VTS and am absolutely passionate about it. I love the opportunity to invest in practice managers, and what better way than through the VTS?

This year we have 16 trainees supported by 16 educational facilitators (trainers). We want our trainees to learn not only about the business of general practice, but to be aware of the bigger picture and how the Scottish government's health agenda impacts on general practice. Health is a devolved issue and GP commissioning is not on the agenda. At their induction, I tell the trainees we are preparing them to be strategic business managers – not for a wee job at the doctors.

With the three aspects to my role, leading the VTS and the Practice Management Network and representing practice management at the highest levels, my job presents its own challenges – but I enjoy every one of them.