In some places across the country, Primary Care Network (PCN) managers have struggled with their local practice managers (PMs). This has, on rare occasions, led to the PCN manager resigning from the role, claiming that the job is “impossible”. So why is there sometimes tension between PCN managers and PMs, and are there ways of avoiding this?

The first thing to say is that there is (as there always is!) a range when it comes to how well these relationships are working. There are some places where the PCN manager is regarded as a “godsend” by the PMs, as they’re providing some welcome relief from the strain that the PCN work has added to their already overstretched working week. In other places, however, the PCN manager is seen as someone who’s taking control away from the PMs and adding unnecessary bureaucracy just when it’s least needed.

We discussed this tension in the latest episode of the Practice Index Practice Manager Panel podcast. It seems that one really important factor is how the role is first introduced. If a PCN clinical director unilaterally decides that a PCN manager is needed and recruits one without any PM engagement, then problems are much more likely to occur.

For the PCN manager role to be a success, there needs to be a strong, supportive relationship between the PMs across the PCN and the PCN manager. We all know that without that in place, the chances of success for the PCN manager are very limited indeed! But if the PCN manager is imposed on the PMs by the PCN clinical director, it can get that relationship off to an extremely rocky start.

Where there are difficulties, there are two really important things to focus on. The first is communication. PMs like to know what’s going on, so for a PCN manager to gain the trust of PMs, they need to be communicating constantly. Sometimes the PMs may need to encourage the PCN manager to up their communication to attain a level they’re comfortable with!

The second is understanding where the PCN manager role starts and the PM role ends. This isn’t always easy to work out, and sometimes PMs need to develop confidence in their PCN manager’s ability before they’ll entrust things to them. If the relationships aren’t working out, the PMs can come together in a really useful way and agree what they want the PCN manager to be doing and encourage them to focus on this, and then support the PCN manager to do these things effectively.

At the end of the day, there’s far too much work for everyone for these relationships not to work. As the demands and staffing and funding via PCNs get greater and greater, PMs will need PCN managers to not only pick some of this up but also to do it effectively. If it isn’t too much already to expect PMs to be doing this on top of their day job, it soon will be!

PCN managers and practice managers have far more in common than they have differences. They’re both roles that are isolated, even within their own organisations. Finding effective ways of working together and supporting each other will ultimately always be well worth the effort.