For the last 14 years, I’ve been running a practice and HR consultancy and during this time I’ve worked with many PMs all over the country, both in large multi-site and small single-handed practices. I’ve also run many training workshops on managing people, personal development and organisational management.

Most managers tell me they’re finding it increasingly difficult to manage their workload. I can relate to this as prior to becoming a practice and HR consultant, I was the practice business manager of a large training practice in Hertfordshire for 11 years. It was a busy job but I think things have become even busier for PMs since then, and PMs’ levels of responsibility have increased too. Take, for example, the CQC and other compliances, as well as the increased complexity of HR management and more complicated IT systems, not to mention the challenges of working more closely with other practices.

The PM is usually responsible for all areas of the practice, including people management, financial management, IT and operational systems, compliance, contracts, facilities management, health and safety, patient services, patient complaints and liaising with external stakeholders. It’s a bit like the job of a CEO of a small to medium-sized company.

In my experience, there are three types of managers: those who are always busy but managing to keep on top of everything and they know what’s going on throughout the practice; those who are frantically busy and just about keeping on top of everything but working long hours to do so, sometimes feeling very stressed; and those who aren’t managing to keep on top of things, who are failing to meet some deadlines and are unable to do non-critical tasks through a lack of time, making mistakes and feeling overwhelmed and highly stressed. I’ve yet to come across a PM who’s twiddling their thumbs and bored – if you’re one of these, or you know of one, please let us know!

So, is the job too big? It depends on how you look at it, and the size of the practice. Although there are core duties for all PMs, the larger the practice, the more there is to manage. I think it’s reasonable for there to be one person at the top of the tree, working alongside the GP partners, who’s ultimately responsible for all areas of the practice (but this doesn’t mean they should be doing all the work themselves). This model provides leadership for the staff and enables a good overview of what’s going on in the whole organisation. However, this model does need other people to help with the management work; people of the right calibre should be there to support the PM. This is where things can fall down. Many managers find it difficult to create the right structure to support themselves for a variety of reasons, including feeling that they should do everything themselves, a failure to find the right people to support them, or unsupportive GP partners who are reluctant to invest in the appropriate calibre of staff.

So, what’s the answer? A useful starting point is your job description. Try to ascertain what you’re actually directly responsible for and what you can/should delegate to others (we’ll look at delegation in a later blog). If you’re delegating, have you done this effectively and is it working? If not, why not? It might be that you can’t rely on work being done properly because the wrong person is doing it, or you have difficulty in the act of delegation itself.

This kind of pondering may result in the realisation that you simply can’t do everything yourself and you require proper support, which needs to be paid for at the appropriate rate. This is likely to involve a conversation with your GP partners and that can be difficult for some managers, especially as you’ll be aware of the potential financial impact. I can only encourage you to create a case and put forward a proposal that’s realistic; stand your ground. Many GPs want to support their PM but don’t fully understand what the job entails – so spell it out with a meaningful job description in your hand. Sadly, other GPs are so overwhelmed by their own high workload and stress levels that they have limited sympathy for their manager’s similar situation. I’m aware of a number of cases where a perfectly capable PM has been so overburdened with work and felt so unsupported that they’ve left and gone to another practice, while the GP partners at their outgoing practice have spent more money on a new manager and ended up employing more staff to support them. It seems crazy! Of course, there’s more mobility in practice management than ever before and you’re a marketable resource, so although most PMs don’t want to leave their job, it might be the best move for you personally if all else fails.

Here are some simple tips that can help with time management:

• If you’re unsure how you’re using your time, keep a log of your week broken down into half-hour chunks of time and at the end of the week, review your efficiency.
• You may find that much of your time is taken up with meetings, but are these efficient ways of spending your time?
• Team meetings can be extremely useful if there are clear agendas, good chairing and agreed outcomes; if not, they can be a waste of everyone’s time. I’m a big believer in regular one-to-one meetings with direct reports, but other one-off meetings can feel like others are hijacking your time.
• Learn to manage one-off meetings by politely giving time limits at the start and keeping to them. Sometimes you’ll need protected time to get on with complicated work, so make sure others understand that you can’t always be available.
• Get into the habit of decluttering your working space and managing your emails so they don’t become overwhelming.
• Ensure you have regular breaks, including lunch breaks (yes, I know most of you eat a sandwich at your desk!), because having a break, particularly one involving fresh air, will give you more energy to proceed.
• Finally, make sure you have relaxing breaks from work to unwind and switch off completely.

Many PMs find that offloading their worries and concerns to a trusted fellow manager can be helpful and can encourage mutual support. Coaching is also an effective way of helping you to unpick what’s going on, to help you find the right solutions and pathways to achieve a better work-life balance. We will revisit the topic of coaching further in our series of blogs.

Written by Patricia Gray. More information on Patricia’s coaching programme can be found here.