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At the heart of general practice since 1960

How to... succeed in a mixed practice

The trend in general practice toward a collegiate model, incorporating individuals with varying skills and responsibilities, has led to a re-evaluation of the relationship between GP principals, associate GPs and other staff.

In order for this realignment to work efficiently and harmoniously, the following should be considered:

1) Define the role expected from each individual, unambiguously, in a practice agreement (for partners) and job descriptions (for other staff). Ensure that job descriptions incorporate a degree of flexibility; after all, you are dealing with professionals, not bureaucrats.

2) Recognise and use individual interests and skills. Does a doctor have a specialist qualification, such as a Family Planning Certificate, that can be used to set up a local enhanced service? Has someone shown a particular aptitude for IT and if so can they assist others in maximising the potentialof provided software?

3) Allow these interests to flourish. If possible, give the individuals dedicated time to develop their interests in a way that contributes to the practice.

4) Delegate responsibilities – such as specific QOF target areas – to those happy to take them on.

5) Use incentives. A significant portion of practice income is tied to targets. Reward individuals financially for achieving set goals.

6) Avoid extravagant disparities between workload and income, either between partners or salaried doctors. Unjustified variations breed resentment and result ina lack of motivation.

7) Encourage an atmosphere of inclusion anda feeling that everyone has a stake in the practice. Involve everyone in practice meetings and decision-making processes.

8) Socialise, both in and out of the practice.

The diverse talents in a mixed practice need to be tapped in order to succeed in these increasingly competitive times.

Dr Jim Sherifi is a GP in Sudbury, Suffolk

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