Manager Practice
two jobs and I’m happy to carry on as long as my health and enthusiasm hold out.” Should the NHS reforms go ahead, GP consortia like
Stafford and Surrounds will in 2013 begin commissioning patient servicesdirectly from hospitals and other providers. Many of the Pathfinder consortia have already launched local commissioning initiatives. In Stafford and Surrounds one of the most successful of
a number of programmes has been the Greyfriars Therapy Centre. The consortium developed a detailed business case for the PCT to lease and adapt a new building in order to provide a one-stop shopfor a range of local social and healthcare services including pain manage- ment, pulmonary rehabilitation, rheumatology, orthopaedic triage and out-patient general and dermatological surgery. It also gave the consor- tium the opportunity to start to integrate health and social care teams by co-locating them in the same building which is an impor- tant element in the government’s reform plans. “The benefits are several-fold,” says Steve. “You don’t want
to go into hospital if you don’t have to. The service is provided in a less daunting, less clinical environment. The quality of care is better than in a secondary setting and the risk of contracting a hospital-acquired infection is much less. It also falls within government aims of providing care closer to home and it saves the health economy a significant amount of money because it’s done at 70 per cent of national tariff – that’s a 30 per cent saving. And patient feedback has been fantastic – with 98 to 99 per cent satisfaction ratings.”
CUTTING RED TAPE The consortium has also delivered a number of other new initiatives in the past year including the expansion of its community ENT triage service, the launch of new services in stroke care and primary care mental health along with other projects in dementia, end-of-life care, diabetes and osteo-
porosis.Steve is an ardent supporter of GP commissioning. “The one thing that irritates me more than anything is
bureaucracy,” he says. “I cannot tolerate pen-pushing and filling forms for the sake of it. What we have been able to see and do with PBC is cut through all the red tape and get things done a damn-sight quicker by driving it ourselves. Left to
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the PCT, I do not know if the local health economywould have achieved half of what’s been accomplished by PBC.”
But the devil is in the detail and Steve believes it is crucial
that established Pathfinder consortia lead the way. He also sees an important role for practice managers in the success of GP commissioning. “Practices will be taking responsibility for devolved
budgets which will probably on average be around £8 million to £12 million a year. Practice managers will have to up-skill and start working smarter. The ability to prioritise and time manage will become crucial.”
I NEVER DESCRIBE MYSELF AS WORKING FOR THE NHS. I CONSIDER I WORK FOR A BUSINESS… AND THE PRODUCT WE DELIVER IS QUALITY PATIENT CARE
Steve even foresees the possibility of someday
having specialised practice managers much as there are specialist GPs. “In a consortium you might have practice managers who specialise in finance or HR or health and safety or clinical policies. And the skill set might be interchangeable between practices.” Having some formal training in management and busi-
ness will also become more important for practice managers. Steve recently undertook a Certificate in Healthcare Finance which included a module on GP commissioning andwould recommend it to any practice manager seeking to enhance skills. His view is that GPs can provide the clinical drive in commissioning but it may largely be up to PMs to drivethe management, adminis- tration and vision. Steve has no illusions regarding the pitfalls and
complexities facing the new NHS reforms. “It’s a mammoth task pulling practices together to
work cohesively,” he says. “But it’s got to happen because the NHSas it is now is not sustainable.”
Jim Killgore is an associate editor of Practice Manager
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