Championing practice management: The vision behind the Institute of General Practice Management

Question: What inspired the creation of the Institute of General Practice Management (IGPM)?

Robyn: It began from shared frustrations among Practice Managers about being excluded from decision-making in healthcare, despite being responsible for implementing changes and running the business on behalf of the General Practice Partners. The government’s “New to Partnership” scheme excluded Practice Managers with the justification from NHS England being that we are “not a profession.” This drove us to establish IGPM around six years ago to advocate for our role and gain professional recognition.

Question: What is the significance of National Practice Manager's Day?

Robyn: It celebrates Practice Managers and coincides with IGPM’s incorporation date, 21 April. Over the years, IGPM has gone from strength to strength. We have grown to 1,600 members, with 300 accredited professionals, and for the first time this year included in consultations around the new GP contract. We have also expanded accreditation to PCN managers and dispensing managers.

Question: How has IGPM accreditation benefited Practice Managers and the government's view of Practice Managers?

Robyn: I think there has definitely been an improvement. We've spoken to the Department of Health and Social Care Select Committee at Westminster to explain the role of Practice Managers and how important it is to be included because of our operational expertise. I think we are getting to the point where we would like people to think that becoming a Practice Manager is a potential career opportunity and have been working with apprenticeship providers and other educational establishments to make it something known and advertised. Being an NHS manager doesn't just mean working in a big hospital or in a large primary care organisation, it also includes general practice. We feel like we have raised the profile and are hopeful that the accreditation framework does its job in acting as a tool for development for employees within practices who want to progress towards becoming the next generation of Practice Managers.

Question: What was the process and reasoning for developing the accreditation framework?

Robyn: It's very interesting because it's the question of how do I quantify what my job is? As my job is massive and so varied our first drafts of the framework included writing down every task that we are responsible for which created something like a seven-page job description! Tasks included anything from strategic business planning to completing a fire risk assessment, demonstrating the breadth of the role and the different levels of responsibility involved. Eventually we managed to correlate it all into the ten domains of the accreditation framework. What this has done for enabling an understanding of the Practice Manager role can’t be denied because you can show your GP partners, who for example might be doing your appraisal, that this is my job and in each of the ten different areas this is the work that I've done against those different areas. The feedback we have received from our members is that their GP partners now understand the job a lot better and our members are much more supported because accreditation has shown how varied and complex the job is. We have also seen our members use their appraisal toolkit or their accreditation application to get themselves offered partnership because I think it causes the GP partners to realise how integral the Practice Manager is. Many GP's have now said to us, if a GP leaves, you can generally get another GP and be okay but if the Practice Manager were to leave, it would be very difficult for them to be replaced due to the level of knowledge and experience that they bring to that role.

Question: What is the purpose of the accreditation framework?

Robyn: Accreditation validates a Practice Manager’s skills and contributions, building confidence among employers and peers whilst standardising the process. For example, when GP partners are recruiting Practice Managers, they should be looking out for people who have MIGPM status because then they know that they've got a fully accredited, high-standard Practice Manager.

Question: What are the benefits of IGPM accreditation?

Robyn: For members, it's a validation of everything that you've already done as it is a skills-based assessment process that is reviewed by your peers who recognise the variety and complexity of the role. Being accredited gives Practice Managers a standard to uphold and confidence to your employers or fellow partners about your achievements and capability. The biggest benefit for us as members is accreditation enables us to have the conversations that are impacting our jobs and offer our unique perspective.

Question: Can you tell us a bit more information about how the accreditation framework aides Practice Managers progression to partnership?

Robyn: It also helps Partners consider partnership for their Practice Manager. There was a recently published study that shows that practices that have Practice Manager partners as part of their setup have better outcomes, not only for patients but also in terms of reduced staff turnover and higher income generation. I was offered partnership in my practice three years ago which I took because I absolutely love the practice. In return, my practice now knows that I am going to be here until I retire. This is my commitment, and I wouldn’t have taken on this commitment if I wasn’t intending on staying and making the best that I can for this practice.

Question: What would you say are the most important skills to develop for someone wanting to be a Practice Manager?

Robyn: You definitely have to be resilient because it’s a big job and a lot of people look to you for guidance and clear instructions on what to do whether that's managing up or down. GP's aren’t trained to be employers - instead they are trained to be doctors and so they look to you for your advice. Communication skills are really important as well as learning how to be a mega multitasker because this is the kind of job where you come in one day with a plan for the day and then something else will always come in that you have to manage or deal with. Having the ability to adapt and be flexible quite quickly is very important as well as not fearing change as the NHS changes every year.

Question: What advice would you give to new Practice Managers?

Robyn: Resilience, adaptability, and strong communication skills are essential. Don’t think that you are alone in this so go out and find a buddy. Seek support networks, such as local forums and IGPM, or reaching out to a Practice Manager at a neighbouring practice and asking for support. We have also created a Whatsapp community for asking questions about any topic which has been massively valuable as there are thousands of members within the community so there's always someone to reply and help. Don't think that you are doing it by yourself because you aren’t and the worst thing that you could do is isolate yourself, because without the support it is too much for one person to manage on their own.

Question: What are the biggest challenges currently facing Practice Managers?

Robyn: Succession planning is critical, if we aren’t growing our own talent internally (which quite often is the case) this might present difficulties. For example, I have a fantastic management team and surgery however none of them want to be the Practice Manager as they see my job as too stressful. A lot of Practice Managers are now coming in from other areas or industries that require similar transferable skills. Practice Managers and their Partners need to be thinking about when their Practice Manager is about to leave and who is coming up behind them. In doing so they need to ensure there is an opportunity for handover and for training to prevent anyone being chucked in at the deep end. This is where the apprenticeship programmes that we are trying to encourage come in. By training staff internally and highlighting the profile of the role, people who are leaving education and looking for a future management position can come in, learn on the job and become accredited.

The other main challenge is the constant change and how we manage these shifts within the NHS contract. The Practice Manager is the person who has to operationalise all of those changes and make things work with reduced funding and a lack of resources whilst managing the team's stress levels and deal with the implications every time that a new contract comes out - which at the moment is every year. We're just waiting for that new long-term contract and trying to stay motivated in managing the constant change and implications.

Question: What can Practice's do to support you better through those challenges and to support Practice Manager's generally within their role?

Robyn: Recognition and checking in on your Practice Manager even if they look outwardly like they're doing absolutely fine, pop in and ask is everything ok? Or can I support you in anyway? Downtime is also very important and one survey worryingly showed that a significant proportion of staff felt like they couldn’t take annual leave because there is no one there to pick up their work when they're off. We know that’s the case - however we need to take the leave anyway and the partnership needs to ensure that their Practice Manager is having regular downtime and the opportunity to switch off. Also partnerships should check their structure and ensure that it's resilient – having everything rely on one person only creates a potential single point of failure!

Question: What do you find most fulfilling about being a Practice Manager?

Robyn: It’s a dynamic role where you can make a tangible difference and be an integral part in the machinery of the practice. I work closely with a dedicated team that feels like a little family. I love that it's a job that challenges me, keeps me interested and engaged and allows me to contribute meaningfully to the community. It’s never boring!

Question: What’s next for IGPM?

Robyn: We aim to expand our membership, enhance our accreditation programme, and continue advocating for the profession. Our goal is to ensure every Practice Manager feels valued, supported and equipped to lead effectively in a challenging healthcare landscape.