By Alan Moore

There is no doubt that managing a GP practice has become far more “technical” that it ever was and I use that word deliberately, instead of “professional”, as practice managers have been professional since 2004 and the first New Contract.  We operate in a highly technical and very fast-moving setting, and if you believe as I do that the overriding role of the manager is to manage risk – to the patients, the staff and to the practice (including the partners) – then what the management theorists call “Environmental Monitoring” is one of the technical skills we need to develop.

I know that many practice managers realise that when you are up to your neck in alligators, it’s very hard to remember the initial objective was to drain the swamp. However, time management would be the topic of another article!  I want here to champion the need to be fully aware of what is changing ‘out there’; for practice managers to become involved in external tasks, to volunteer even a very small amount of time doing something that extends their awareness of an NHS that exists beyond the practice.

The internet has been a godsend in this respect. We all complain about “NHS Spam” – not the cooked meat that can figure on hospital menus but the sheer volume of material that hits our email inboxes. The problem is that some of it is important. Device alerts and NICE or Public Health circulations almost always seem to be directed at secondary care issues. If the practice has at least a system in place where someone who is clinically aware gets to read them and ensure action is taken, where necessary, and documented/disseminated accordingly then one potential risk has been covered.

What about the wider issues? Do you look ahead to see what is changing in the NHS overall? Do you look at the implications of changes to secondary care that might just cause primary care a problem? The off-loading by secondary care of tasks such as discharging patients without the medication they need, and expecting the GP to do it must surely have been predicted as part of the budget savings they were expected to achieve! So… has the practice already been pressing the CCG to be robust in their commissioning of secondary care?

Have you read the NHS forward review documents?  Did you read the CQC standards when they were amended to reflect the new inspection regime (even if you read the initial standards that were changed)? Do you look at ‘Nigel’s Surgery‘ on the CQC website to see what advice there is on nearly 80 important topics? Whether you are looking ahead 10 years, 5 years or just next year, there are sources of information that are easily available and which you can use to shift the practice into the best position to take advantage of changes that are coming.

I am willing to bet that many practices were taken by surprise with the Accessible Information Standards (policy here) that were compulsory from the end of July this year. I also bet that the changes to the requirements for ‘Infection Control’ which came in 12 months ago have passed many IPC Leads by as well.

I ask the question… If your practice manager locality meetings haven’t as yet tasked people with monitoring a specific area they either volunteer for or are appointed to do, then what are you waiting for? Do not just look at the immediate technical issues, because strategic planning – looking ahead – is equally important. Being ahead of the game is just as good a time saver as all of the time management ideas I could have come up with! What about ‘risk’ I hear you say? Well anyone who has spent days of work dealing with GMC, Ombudsman or litigation paperwork will already have spotted that acting early to reduce the risk of getting something wrong, would have been just like shooting alligators before stepping into the swamp.