Launched in 2005, Management in Practice has now been running for nearly five years. In that time, primary care has undergone enormous change. In fact, it seems strange to think that back at the time of our launch, general practice was still in the process of adapting to the 2004 GMS contract.
To practice teams' enormous credit, what was a seismic shift now seems rather ordinary (anger over out-of-hours arrangements notwithstanding), and initiatives practice managers have had to get to grips with – such as the Quality and Outcomes Framework (QOF), practice-based commissioning, world class commissioning and a quite extraordinary range of acronyms (LES, DES, I won't go on) – now seem commonplace.
With a general election looming, could 2010 be just as decisive to general practice as 2004? New challenges, not least looking ahead to significant NHS spending cuts and coping with ways the health service responds to this, are likely to give practice managers yet more to contend with.
One of the central aims of Management in Practice has been to create a virtual community for practice managers, in which members of this profession can share opinions on the changing face of primary care.
Highlights on this website have included blogs from Kate Harlow ("I am of course always motivated by the desire to see patients receiving the best possible care, but it can be demoralising to be constantly obstructed by perverse and unproductive policies"), Gloria Middleton ("I would want Lord Darzi to work in my practice for a week. I could introduce him to the PBC Cluster so he can see what excellent work is going on – and yet we have no funds to redesign services or be instrumental in making changes") as well as the hundreds of ongoing comments we receive in response to our news stories.
In this crucial year, we'd like to hear more from practice managers on the new challenges now facing primary care. I'm inviting our readers to put themselves forward as bloggers – to share your views, arguments and experiences with our online readers and to open up debate on key issues. For instance, what do you think to the "culture of dependency" in primary care? Or the state of out-of-hours services? Or the reorganisation of community services?
If you're a practice manager with strong views about the condition and future of general practice, I'd love to hear from you – please email me at at firstname.lastname@example.org. I look forward to hearing from you.
Furthermore, we'd like to know more about you and what you'd like to see from Management in Practice, and so we've launched a short reader survey with a few questions about your role and the kind of content you'd like to see more of in MiP.
Please help us to help you by taking a couple of minutes to complete the survey. Simply click below to start. Thank you.
How would you like to see primary care change for the better? Your comments (terms and conditions apply):
"Get rid of 90% of the PCT! All I ever get is moaning and obstruction. How exactly can 100% not be good enough for child imms? But I had to have a meeting to explain what I was doing to improve results so myself and a nurse each wasted time explaining to the PCT why we could not improve on 100% – and that is just one example of many of complete idiocy. My first cut would be improvement managers. Why do we have development and improvement managers? Surely every development should be an improvement or am I missing something here?" – Name and address withheld
"By taking control away from government, who use us as a toy where they can bend and twist us to suit their needs and not necessarily what is best for the public. Also stop telling the general public they can have what they want, when they want even when they don't need it" – A Mayhew, Newcastle upon Tyne
"There have been great improvements in the NHS over the past 10 years, with 40,000 more doctors and 80,000 more nurses, plus the reduction in waiting times from 18 months to 18 weeks or less. However, what has been less welcome is the thousands more managers created. These are resources that could have been used directly on frontline services. The NHS does not require endless auditing and managers created to manage other managers. A layer of unnecessary red tape and bureaucracy has been created. If cuts are now needed due to difficult economic times then this is an ideal time to have a bonfire of all that red tape. We need someone like Digby Jones to root out the waste but all he needs to do is come and talk to the people working on the frontline. The government needs to be very careful to ensure that frontline services and staff are not cut. Perhaps the only way to do it is to cut PCTs down even further, so that we are virtually left with only regional organisations or even abolish PCTs completely. There are also a handful of useless quangos that could be thrown on the bonfire too. So let's have a red-tape tsar in the NHS with the remit to report quickly on a much slimmed-down bureaucracy. Billions of pounds could be saved by cutting out the waste on bureaucracy leaving the frontline services intact" – David Jones, Tunbridge Wells