Sandra began life in general practice as a receptionist. A rethink, while on maternity leave, nudged her to apply for a practice manager role, which she has held for nine years. She now has an extremely busy life in the practice and as chair of a GP federation, as well as family commitments. She carves out a little time for life-drawing, cycling and the theatre and has completed a London Marathon.
“I had been co-chair of the practice managers’ forum. Previously I had enrolled for an AMSPAR/ILM course but didn’t complete it due to my pregnancy, then my twins came along and later I cared for my late mother.
The programme came at the right moment for me. I had been looking to do something outside the practice, such as a role on the locality board, but there were barriers. As a practice manager, it can be hard. The role tends to be overlooked. They are usually looking for GPs to get involved rather than other practice staff.
I have more conviction about what I’m doing
I suppose the programme has ignited a bit of ambition in me. I have more of an appetite for challenge and have more confidence in my own skills and abilities and in what I have to offer. I used to find it difficult to speak up in meetings, now I chair some quite large meetings. I have more conviction about what I am doing and am less inclined to wait and hear what other people think before making up my own mind.
The programme has added a lot of discomfort to my life, which is good because my threshold for what I might find difficult has increased. It was good working with others who felt the same ‘imposter syndrome’. These are people I really respect and we shared those feelings together.
It’s been interesting to see some GPs’ change in attitude to practice managers. It’s a relatively new profession and the group of really good practice managers on the programme has raised our profile.
I’m used to being in charge!
There were times on the programme when I found it difficult that someone else was leading. I’m used to being in charge! I realised that I like hierarchy and sometimes found it hard to work in the collective leadership structure of the programme. You have to find ways of working to a concensus and that can be difficult. If you’d asked me before I would have said ‘I’m a team player’ but actually but when it came to it I defaulted to taking control. But sometimes people, including me, do want another person to step up.
Once we got going and had direction it was really good, though it took a while for the programme objectives to be clarified and for us to know our remit. The time has flown by and so much has happened with the setting up of the federations. The programme was responsive to our needs and the coaching, for example, was very helpful for dealing with some knotty federation problems.
Federation enabled the practices to work together
The federation has already benefitted patients. Even before we set up the Extended Primary Care Service, Lambeth established winter access hubs which I was heavily involved in. Before the programme I wouldn’t have known where to start or had the connections and relationships to make that happen. The federation enabled the practices to do this together which would not have happened before. Our patients are being seen at the access hubs and they are satisfied with it. Another positive outcome is in holistic health assessments. Activity was really poor before the federation got involved and now we are doing thousands of assessments a year.
But it is hard to manage being away from the practice. To start with I backfilled myself by working extra hours but that wasn’t sustainable as the federation work increased. We decided to take on an assistant practice manager. People had to get used to me not always being around.
It would be hard to step back
I’ve invested so much and have been involved in federations from the start it would be hard to step back but there is the feeling of whether I am putting enough into my practice. However for the federation it’s helpful to have a grounding inside the practice. You bring a perspective of what it all means on a day to day basis as well as a view of how it might work more broadly and strategically.
The real risk is burn out. I am really tired and my family suffer from me committing so much to this. My hope is that as the federations grow we have bigger teams and better infrastructure so that my involvement in day-to-day tasks can be reduced. Hopefully as more practices become more engaged and involved and seeing the benefits of working together, the roles in the federation will become more manageable.
A mix of roles not just one job
Doing the programme has made me think even more positively about learning and development. It’s so important that we give opportunities to people in practices rather than pulling in people from outside. Lots of people want to have a mix of roles not just one job. It has made me think a lot more about practice managers’ development too. I’ve gone to the Community Education Providers Network (CEPN) in Lambeth and now we’re developing a workstream on practice management.
Sandra Connolly is Practice Manager at Beckett House Practice in Lambeth and chair of the North Lambeth GP Federation