Dr Neil Turton Chief Executive 16th October 2013

1. Practice Managers – a new breed Dr Neil Turton Chief Executive 16th October 2013

2. What is a Practice Manager? Dr Turton’s remarkably unscientific analysis of The Practice Manager! First Practice Management Responsibilities of the post of 'Practice Manager There is of course the hugely vexed question of the responsibilities a post carries, which has the title “Practice Manager”. We know responsibilities range widely. While it was suggested to us that we should first agree and define the responsibilities, we concluded that this was simply not possible for our purposes as the variation is too wide, and so we simply based the results on responses from those who carried the title “Practice Manager” or similar, or who undertake a similar role.  Practice Manager Salary & Bonus Survey 2012 NHS Careers Practice managers … work within the primary care sector, where they manage the overall running of general practices (GP surgeries). Collins English Dictionary practice manager (ˈpræktɪs ˈmænɪdʒə)  Definitions noun the manager of a business such as a medical practice, dental practice, or legal practice Someone who is called a Practice Manager! Wikipedia The page "Practice manager" does not exist. You can ask for it to be created

3. Who is running this business? We are! About £9bn per year 40,000 GPs (30,000 FTE) 75,000 practice staff (FTE) 8,100 practices 99% of population 300m + consultations per year 90% of NHS contacts

4. What about the challenges ahead?

5. It’s a big challenge!

6. How will we get there? Gentlemen amateurs? Highly organised & trained professionals?

7. What’s the future of General Practice? A sustainable system of general practice requires increases in scale, scope and organisational capacity, while preserving the local small-scale points of access to care that are highly valued by patients.

8. Case Study: Salford Health Matters CIC A social enterprise born in 2007 Community Interest Company One of first wave NHS ‘spin-outs’ 15,000 patients 3 purpose built premises across Salford Multi-disciplinary team (44 staff) Specialist homeless service Ground-breaking children’s A&E avoidance project (GP Awards and HSJ Awards finalists) Social prescribing in partnership

9. Our Achievements 2007 - 2013 5 former PCTMS practices Initial 5 year APMS contract 11,500 patient TUPEd staff from separate teams Low staff morale Poor satisfaction Minimal patient involvement No trainees Vision + Emis server based systems 64% QOF Cost PCT £1.9m / year No return on investment 1 Practice over 4 sites + homeless, children’s, and social prescribing Secured on-going PMS contract 15,000 patients All salaried staff in one organisation Investors in People / good morale High patient satisfaction (mostly!) Patient Forums at each site GP, Nurse & social worker training Common web-based IT platform 96% QOF, CQC compliant Cost £1.5m / year (on £2m turnover) Reinvested £120,000 in services We now run… Co-ordinated More efficient Cost effective Multi-disciplinary High performing Primary Care Services We inherited… Fragmented Uncoordinated Costly Inefficient Poor performing Practices 6 hard years!

10. Our Structure

11. Site 7 franchise Site 5 Site 1 Salford Site 4 Site 2 CBU Service B Site 3 Service A Site 6 New area, e.g, Trafford Our business model

12. Our Central Business Unit (CBU) • The CBU provides the corporate infrastructure • Corporate Governance • Finance • Human Resources • Quality Standards • Contract Management • IM&T • Estates • Health & Safety co-ordination • Business Continuity co-ordination • Communications & Engagement • Project Management • Business Development • Central Administration

13. Learning Points Clear focus provided by company mission and values Focus on quality – set high standards, invest in staff, PDR & training Specialised roles – Finance, HR, Contract Performance, Business Development Establish common systems and process (adopted a ISO9001 approach) Necessity is the mother of invention – £100k year on year contract value reduction Be consistent and systematic… but also shake it up – restructure, new roles, etc Learn from mistakes and celebrate success - staff contributions, awards, etc. It’s bloody hard work and we’re not there yet…

14. Where next? Our Business Strategy Short-term: business improvement & consolidation Investment in Leadership Improve patient experience - add value at each stage in patient pathway Further develop homeless, children’s & social prescribing services Medium-term: organic growth Steady list increase Explore staff ownership model Develop a new multi-agency health centre Deliver integrated care services Extend access Practice acquisition and / or shared services

15. We are up for the challenge… …Are you?

16. Thank you salfordhealthmatters.co.uk neil.turton@nhs.net 0161 212 5818 07824 505 217