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The driving seat – Is it still uncomfortable?

by in GP Practice Management, Opinion

Having spent some time recently back in the driving seat, after a few years of being at home on the range, I realised that while the workload is changing all the time, the attitude of employers towards their staff and their practice managers hasn’t changed much at all. My concern has always been the salary you’re paid, and the paid hours of work you work. But my concerns have also taken into account workload, stress, lack of training and whether the expectations of what you can do are realistic. This could even lead to words like ‘unreasonable’, ‘bullying’ and ‘harassment’. I recall an employment tribunal case involving a practice manager who regularly worked in excess of 48 hours per week, and her employer who took little or no interest in her plight. The effects of working in a stressful situation kicked in and she left, claiming constructive dismissal. She won her case.

Do you need any help?

Personally, I found it was impossible, for instance, to help run one practice working 16 hours per week. I’d worked in other practices working for three days, 21 hours per week. I found this more manageable with the help of a good team of doctors and staff. They took an interest in what I was doing, making a point of saying hello and can we help you. It made a difference. But even for a full-time practice manager, are there enough hours in the day and do you have a strong enough argument to employ a deputy?

Are you working part-time?

Working in a much larger practice with over 15,000 patients, eight doctors and 25 staff, even ten years ago, I found it difficult to do the job in 37.5 hours per week. I often worked from 8am until 6pm plus Saturday mornings and recall, much to my annoyance, being challenged if I arrived late or went home early – and this was by the staff!

No overtime payments?

In the NHS, senior managers aren’t permitted to claim overtime payments. This would include staff paid on AFC Pay Bands 8 and 9 (starting at £44,606 per annum from April 2019). But what if you’re contracted to a 37.5-hour week, but consistently work over 40 hours per week? How much income are you losing? Your pension may be affected. Should you be formally contracted to work a 40-hour week and paid accordingly?

Oh, not just a fuddle!

Looking at Practice Index threads over recent years, there’s been mention of staff being paid a bonus, but in reality, there does seem to be a reluctance to pay bonuses even though the efforts of practice staff have earned practices more money. It’s nice to have a thank you now and again, and maybe a party, a fuddle or a gift voucher, and in one case I witnessed recently a certificate of appreciation. But it hardly recompenses staff for the hard work and the time they’ve given the practice.

Saying boo to a goose

The problem, as I see it, is starting to say boo to geese (geese can be intimidated by someone shouting at them). Not an easy thing to do with your employer! GP staff in the main don’t have advocates in the form of trade union officials – though nurses do. Building an argument that you’re not being paid for what you do is tricky. Try this set of questions!

  1. Do you regularly work more than 37.5 hours per week? (Yes)
  2. Do you regularly work more than 40 hours per week? (Yes)
  3. Do you regularly work more than 48 hours per week? (Yes)
  4. Do you work at weekends? (Yes)
  5. Do you work from home? (Yes)
  6. Are your employers fully aware of your extended working hours? (No)
  7. Are you paid for any overtime you do? (No)
  8. Are you allowed time off instead of overtime? (Yes)
  9. Do you take at least a 20-minute break every six hours? (No)
  10. Could you manage your workload in less than a five-day week? (No)

So, have you matched some or all of the answers in brackets? It might help you build your case!

Time managing, yes or no?

Managing your time and your workload is always a challenge and I’m sure we all develop techniques to cope. I’ve been looking at the use of traffic lights, as mentioned in a recent thread, by marking tasks red, amber or green. I remember traffic lights on my boss’s door. Green meant go in, while red meant keep out, but amber meant wait. The use of emails these days has changed the way we work; red might be spam or junk, green might be read it and do it, whilst amber might be read it later or just file it.

Speak now or forever hold your peace!

How much time do you spend communicating with your doctors and staff by word of mouth? How many meetings do you attend, and then spend time writing minutes and reports? Who reads them?

In the end, you have to decide whether you can cope. I’m 68 years old this week and think I should leave the challenge to the younger, fitter ones among you, hoping you’ll be treated well, respected and paid what you’re worth. Make sure your employer is aware of what you’re being asked to do by outside sources. It’s telling how many emails are directed to the practice manager! The crux of the matter is, do you and your employer understand exactly what you do and what you’re being asked to do (during your contracted hours)?

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Robert Campbell

Robert Campbell

Former GP Practice Manager with over 25 years experience working in Upton, near Pontefract, Seacroft in Leeds, Tingley in Wakefield, Heckmondwike and more recently Cleckheaton, West Yorkshire. www.gpsurgerymanager.co.uk

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