Who covers for you when you’re away on leave; does anyone deputise? What do you discover on your return to work after the initial pleasantries and the ‘how was your holiday’ questions? Perhaps you return to a small mountain of admin and find that your office resembles a Royal Mail sorting office, and your inbox has over 150 unread emails? Not the welcome you’d envisaged, I’m sure.

So, what do we do to improve the situation? Well, there are many practices that have a Deputy Practice Manager who steps in and covers for the PM who’s enjoying a much-needed and well-deserved break. That’s their responsibility, isn’t it? Well, by virtue of the definition of ‘deputy’, that is correct: “A person who is appointed to undertake the duties of a superior in the superior’s absence” (Oxford Dictionaries).

It’s not unusual to have a Deputy Practice Manager and, in fact, in most of the practices I’ve managed, I’ve had a deputy. However, in my last practice I did consider changing the structure and introducing the role of Business Manager, and making my deputy the Practice Manager. Digressing? Not necessarily; hear me out.

What I found was that the role I was doing was aligned to that of a Business Manager and my deputy was in fact overseeing the management of the admin/reception teams and administrative processes. However, I then thought about making my deputy an Assistant Practice Manager and when you look at the definition of ‘assistant’, you may see why: “An employee who helps a manager or other employee of higher rank with the completion of activities” (Collins Dictionary). So, you’ll see that whilst the BM would have overall managerial authority of the whole team, the assistant would support them in their role.

Now, I hear the questions: “What about leave and other absences; how can an assistant cover if there’s no deputy?” and “Who has managerial responsibility for the team?” But what do we do? Is there a one-cap-fits-all solution for general practice? Does size matter (the size of the team and patient list)? There are many other questions, I’m sure. I could throw Operations Manager into the mix; would that be the solution? Maybe. After all, the definition of ‘operations manager’ is: “A person in charge of the planning and execution of the routine functions and activities of an organisation”.

Got you thinking? Well, maybe that’s because there’s a lot to think about. Just because you’ve always had a DPM or APM doesn’t mean it’s correct. On the other hand, there’s no need to change things for the sake of it, if things are working well. But consider this; you’re on leave and there’s a disciplinary issue. Who takes the lead? Your assistant? But the definition states that they help you, not that they undertake your duties in your absence; that would be a deputy!

Maybe the answer we’re looking for is an Operations Manager. As PM, you need to focus on all areas of the practice from finance to flooring, security to succession planning. What all PMs need is someone to assume responsibility for the day-to-day running of the practice, enabling you to focus on all the other elements. Step forward the Operations Manager! Why? Well, the deputy hat doesn’t fit, does it? You want someone to deal with admin and reception, staffing rotas, etc. whilst you drive QOF, work on the business plan, review policies and procedures, generate revenue and so on. A deputy would only do that if you weren’t there, wouldn’t they? Yes, by definition; no, in reality.

What’s evident is that we do need someone to cover the role of PM when the PM isn’t around. I’m a firm believer in delegation and it’s an art that takes mastering; only once you’ve cracked it does it work well. And as a manager, you need to delegate tasks, but I’m certain that delegating the task of running the practice in the PM’s absence isn’t an option, particularly for non-managerial staff; this would only be appropriate if you had a deputy.

Whatever you have in place may work well for you. But have you considered all eventualities? Do you ask your receptionist to cover for you when you’re away because they’ve been there the longest? What happens if their colleague has an allegation of gross misconduct made against them? Who takes the lead? Or what if there’s a complaint raised on your first day of leave and you’re off for two weeks? Does the stand-in PM know how to manage complaints effectively and in a timely manner?

In my opinion, and looking at the definitions I’ve presented to you, the role of Operations Manager seems to fit quite nicely. That said, the role of Deputy Practice Manager can fit just as nicely. But what doesn’t fit is the ad hoc covering of the PM’s role while they’re away. There should be a clear and robust structure in place if the practice is to continue to operate optimally in the absence of the PM. If you had an Operations Manager, would you need roles such as Reception Manager or Administration Manager or similar? Maybe, maybe not.

Whatever you do and whatever model you have in place, it must align with the strategic aims of the practice and ensure that the needs of the patient population are met. The benefits of having a nominated Deputy Practice Manager or Operations Manager are that you can develop them and ensure they understand all elements of your practice; this will reduce the risk while you’re away on that much-needed, well-deserved holiday.

What are your thoughts on this? Please comment below or on the forum thread here. 

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