Balham Park Surgery, London
Natalie is a full-time managing partner in Balham Park Surgery, South West London, which has a patient population of 12,300. The surgery is run by a multidisciplinary partnership, which includes a practice nurse. The practice has twice achieved the Royal College of General Practitioners' (RCGP) Quality Practice Award, and was the first practice in London to achieve Investors in People, the quality standard that recognises strong workforce development in businesses and organisations
Continuing professional development (CPD), the process by which we keep updated in terms of our knowledge and skills to maximise our performance, has been put on the back burner for many practice managers in recent times.
We all recognise the importance of keeping our skills up-to-date, of improving our knowledge of the ever-changing business of primary care, and the need to maintain our motivation and creativity in order to be effective – but how many of us are actually finding the time to undertake any?
As a managing partner in a large London practice, with a strong interest in education and the development of people, I consider CPD to be very important. However, I am rather ashamed to admit that over the last 12 months I have undertaken very little personal development, despite the plans that I had.
I booked and paid for two annual conferences this year, both of which I was really looking forward to – an opportunity to network with other practice managers, I thought. Speakers at the top of their game would provide me with renewed inspiration to go back to my surgery and be creative. Time out would give me an opportunity to reflect upon where I have got to and where I am going.
Sadly, a primary care trust Quality and Outcomes Framework (QOF) meeting, a sick reception manager and a looming deadline to submit a not-yet-formulated plan for a directed enhanced service (DES) caused me to send someone else in my place, and I missed out.
In contrast, 10 years ago, when I started in general practice, I was actively looking for opportunities to improve my knowledge of the NHS and leadership skills to use for developing my multidisciplinary team. At that time, I was able to secure a place at the Salomons Centre (now Canterbury Christ Church University), which belonged to the NHS until 1995. They had organised a Strategic Leadership Programme for people in
Thinking back, it provided me with a fantastic opportunity to meet other driven people who wanted to make a positive difference to patient care through their teams. I discovered something about my strengths (I was a great facilitator) and weaknesses (I had poorly developed skills in lateral thinking!), and had dedicated time to develop them further.
During the final phase of the course, we were allowed to select an area that we wanted to gain further knowledge and understanding in. I chose to look at the interface between social services and the health service in Northern Ireland.
At that time, there was talk about aligning aspects of social services in England to primary care. Through special funding, I was flown out to Belfast for three days with a nurse colleague on my course who had a similar interest, and got to visit a couple of general practices, a nursing home and Stormont, the Northern Ireland Parliament. Our kind hosts at each venue took as much interest in us and our experiences in healthcare as we did in them. We returned and delivered a talk to our group about our experience.
I remember the excitement I felt by being selected for the programme, the learning that I undertook, my sense of achievement for getting approved to go out to Northern Ireland, and the impact that the opportunity had on my confidence and self-belief. It definitely made me a stronger manager and gave me a desire to keep on developing myself.
Time at a premium
I recently asked a number of practice managers in my local area, whom I consider to be competent and reasonably forward-thinking, what they had undertaken recently in the form of CPD. Five out of six had not managed to do anything. Four out of five laughed at me.
Linda Hicks, from the Elborough Street Practice (whom I caught at 9.45pm leaving an evening practice-based commissioning [PbC] forum) grunted wearily: "Where's the time to even think about it? I'd love to, but to be honest I have not even considered it."
No one I have spoken to about CPD disputes the benefits but sadly they, like me, have been overtaken by the QOF, DESs, local enhanced services, PbC, community staff restructures and, not least, the daily running of the practice, to name but a few of our pressing responsibilities.
As practice managers, we have to make a concerted effort to place our own CPD as a priority. We are always too busy, and primary care is under constant change, so putting it on hold for quieter times may well mean never! It is when we're feeling beaten, jaded or uninspired that we could benefit from CPD the most, and we really should start planning the steps we want to take – today!
One manager I had a conversation with, Elizabeth Noel, who oversees Furzedown Practice in Wandsworth, told me she had shadowed another manager for a day. She said the reason for doing so was because this manager seemed particularly skilled at getting things done and appeared to be proactive in lots of areas; she wanted to be able to adopt some of her methods and coping mechanisms.
Ms Noel said of the experience that she had thoroughly enjoyed being a "fly on the wall", and that there were things she would tackle differently as a result. She added that she would most definitely encourage others to consider doing this.
There are many opportunities for CPD out there for us, and we can get plenty of support from a number of
Institute of Healthcare Management (IHM)
The IHM provides a CPD framework for managers in healthcare professions to select various activities to fulfil their career and personal development needs. Their website (see Resources) lists the types of opportunities that we might consider, including:
Members of IHM (of which I am one) are required to keep their skills and competencies up-to-date as part of the Healthcare Management Code that they sign up to. The IHM runs a number of programmes for practice managers, which can lead to a variety of vocational and academic awards.
In 2004, I undertook my fellowship with the IHM. Not only did it enable me to focus on my own growth as a manager at a time when I was at risk of stagnating, but I was also able to use the process to enable the development of my management team at the practice, and to revise outdated protocols.
AMSPAR (the Association of Medical Secretaries, Practice Managers, Administrators and Receptionists) is an awarding body recognised by the Department for Education and Skills.
AMSPAR offers a number of formal qualifications, including the AMSPAR Diploma in Primary Care Management (DPCM) Level 5. This programme is suitable for potential and current managers, and covers areas such as:
To achieve the diploma, candidates must gain a pass in five nationally set assignments, and a pass in the business project (including oral presentation).
Management in Practice
The Management in Practice Events are designed specifically for practice managers, and cover topics such as: IT; premises; PbC; human resources; risk management; QOF and finances. The next event, together with an exhibition, takes place in London on 5 September.
CPD for practice managers can take many forms, from simply reading a book on a chosen work-related subject, to a sabbatical with another relevant organisation (I quite fancy that idea). The key things that we need to consider when deciding upon our activities are what we would like to achieve from it and how much it will cost, including how much time we are prepared to commit to it.
In putting this piece together, I have reaffirmed my commitment to CPD. In order to remain effective in my job, I know that I need to put my head above the parapet once in a while.
In future, I am determined that I will not let myself be sidetracked by the everyday workload at the expense of my own development, as tempting as it may be. Neither should you!
AMSPAR (Association of Medical Secretaries, Practice Managers, Administrators and Receptionists)
Institute of Healthcare Management (IHM)