It’s hard to think of an area in the public sector where the improvements in management skills had been as dramatic as those in Primary Care.  However, the pace of change shows no sign of slowing and the demands will require a quantum leap in Practice Management Skills.  In previous articles I have talked about dealing with change. In this article I focus on the managers own personal effectiveness and highlight some of the skills which we believe will be vital for practice managers to enhance.

These include:

  • Effective time management, delegation and empowerment
  • Performance management
  • Influencing and negotiating skills

Time Management, delegation and empowerment
Your time is precious, but many managers do not realise or calculate quite how precious! For instance the raw salary cost of someone on £30,000 per annum adds up to £ per hour, that’s before employment costs and the costs of supporting them in that role with a building, rent, heat, light, power and admin support. Managers need to triage their time.  This means asking yourself whether you need to do all the things you do, or could someone who costs less and does not need your level of skill do it instead?  This would save time and money and provide motivation and development for whomever you delegated that task to. Yes of course you would need to spend time breaking down the task, training the person and monitoring their performance, but it will release you to do the things only managers can do.




You prioritise these tasks using the Eisenhower Grid.  You should be spending most of your time in the important and but not urgent box – if you are always in the important but urgent box, you are not spending enough time planning ahead. For urgent but not important jobs – delegate. For those that are not important and not urgent, consider just not doing them!

To make sure you get those important and strategic jobs done, break down each job into tasks and allocate block of protected working time in your diary for a rolling 6 months ahead or until the job is completed. You will need at least 2 blocks of 2 hours per week. Fix them for when you are your best and demands on you are least.  If you can’t avoid being disturbed, then take yourself off to where you won’t have interruptions.  Do it at home 80% of the 2.5 million people who work from say they more done when they are free of interruptions.

Frequently asked questions
For the question staff always ask, consider setting up an FAQ document on the server- then they can look up the answers instead of bothering you!

Team to do lists
To capture all the things you need to do, run a daily to do list, but also consider having a shared list of the server – a simple word document will do – with all the tasks that every member of your team has to do listed with a page per  person, the  task and a when by date for completion. This way people can see what you have to do as well, you can see who is over and underloaded and you have a ready made progress list on which to base your team meetings.

Performance management
We are often consulted by Practice Managers on our Diploma management courses about difficult members of staff who refuse to change, cause ‘atmospheres’ and are hard to work with.  The question to ask is, ‘If the practice was yours, would you tolerate this?’  I suspect the answer may be ‘No’!   Practices are in the business of delivering excellent care, not providing employment for people who see it as a right, whatever their conduct or output.

Many managers are reluctant to tackle this problem and seem to be willing to put up with the stress, low output and disruption this causes.

Insisting on appropriate levels of performance and conduct is not easy when problem people have been given license for their behaviour by inaction over sometime many years.  However, the majority of hardworking and conscientious staff will welcome firm, consistent and fair interventions by managers and partners.

 Defining Excellence
Begin by defining excellence for every individual. This is defined by the practice by the GP contract. The same should apply for staff. Job descriptions need to have performance standards attached as part of the contract, Competence needs to be defined, spelt out and measured. This will indicate both skill and performance gaps. Skills gaps should be rectified by training and if performance does not follow then, if every help as been given to meet the required standards, and there is no improvement then you should consider the continued employment of the individual concerned.  You can get free advice from ACAS as to your rights as an employer, and provided you are fair, and follow the rules, there is no reason my your practice should carry people who do not contribute to its success and the care of patients

Influencing and negotiating skills
To ensure your practice gets the best opportunities and so that you can convince others of the merits of your vision of how the practice can be improved, you will need to understand and practise sound negotiation & presentation skills more than ever before.

Win/Lose or Win/Win
Some managers believe the only way to negotiate is hard.  This macho approach might be Ok for one off negotiations, but for any negotiation where you are going to have to work with the other party in future, it will simply ensure that if you best them, they will want to get even.

The best negotiations are founded on a thorough understanding of each other’s needs and how you can both compromise to get the best possible result for all.  It is a listening discussing, and trading process.

Some of our management students are shocked when we talk about power in negotiations. Bit if they were buying a house, they would not hesitate to use the power of having sold their own house to get a good price on the house they were buying by offering a short or zero chain.
Power can come from your position, your knowledge & expertise, from opportunity (you have what everyone wants), from the resources you control as well as your listening skills, verbal ability and personal credibility.

Analyse your power in each of these areas, and then do the same for those you are negotiating with to understand and maximise your advantages.

A new year’s resolution?  Improve your professional management skills – you’re going to need them!

Peter Waddell MA MCIM MEI
Development Director
Cherith Simmons Management

1307, 2017

Delivering Management Development in the Public Sector – Some considerations

July 13th, 2017|0 Comments

The Background to the Sector. The public sector is trying to deliver rising public expectations against a background of reducing funds from central government and local taxation which is effectively pegged. This 'rock and a [...]

3006, 2017

Using IT for Personal Development in the practice

June 30th, 2017|0 Comments

In a few short years GP practices have moved to become one of the most advanced areas of smaller business in their use of IT, outstripping both the private sector and much of the public [...]

106, 2017

Making away days work harder

June 1st, 2017|0 Comments

Making away days work harder Many organisations run away days for their staff. Many do not, afraid that the freedom such events give, may trigger a moan fest which senior managers will find uncomfortable.  It’s [...]

505, 2017

Competing for Customers

May 5th, 2017|0 Comments

Customers want more than a result, they want to be treated properly We don’t judge organisations just on the quality of the service they deliver, or even just the content of what they deliver.  We [...]

1904, 2017

Moving to a Multi-skilled Practice

April 19th, 2017|0 Comments

Moving to a Multiskilled Practice. You’ve all heard the announcement in the supermarket, ‘Will all multiskilled staff go to the checkouts’. What does that mean and what relevance does that have to running a practice?  [...]

3007, 2016

Team Building

July 30th, 2016|0 Comments

In earlier times, it was not hard to build a team. The Navy simply sent a squad ashore, rounded up some likely looking lads and hey presto – you have a crew! After time and [...]

1405, 2016


May 14th, 2016|0 Comments

It’s hard to think of an area in the public sector where the improvements in management skills had been as dramatic as those in Primary Care.  However, the pace of change shows no sign [...]