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'Most informative meeting I've had since becoming MP'

Ever considered a career combining medicine and management? Two like-minded, business-savvy GPs working together in a deprived London borough shared a vision for improving primary care in their area. They joined forces with four other health care professionals to create U-Care and bid for APMS contracts with local PCTs. Now they provide everything from cover for failing practices to education. Dr Ijeoma Ukachukwa reveals how they did it

In 2004 I was chatting with a GP colleague with whom I share an interest in primary care management and concerns about the inefficiency and duplication of resources in primary care. Our discussions centred on the ideal system and model of care.

At the time I was completing my MBA at Henley Management College, where managing resources, strategy and marketing in primary care were of particular interest.

After a lot of brainstorming, in August 2005 we conceived the management group U-Care, which stands for a 'unique, caring and responsive enterprise'.

As luck would have it, Government ideas ­ about developing primary care, increasing competition, encouragement of alternative providers of health care, and performance- related management ­ were aligned with the U-Care philosophy.

This alignment stimulated informal discussions with like-minded practitioners in our locality (Brent), and within a week U-Care had a team of six health professionals.

There are four GPs with business experience and an MBA, an optician who is a successful businessman who also holds an MBA, and a nursing manager with business experience and a diploma in economics.

Strengths and weaknesses

The team have different strengths and weaknesses that have been formally assessed to enable us to learn from each other. At U-Care we consider the amount of knowledge and resources among the directors as a major transferable asset.

We have teachers, trainers, lectures and mentors in the team. The directors' varied skills include human resource management, contracts and negotiating, strategy and planning, financial management, marketing and promotions.

Early in the team's history, tenders for APMS contracts were published all around London. U-Care felt obliged to bid, but our efforts were rather disjointed and hence unsuccessful.

Every new team will go through a series of stages ­ forming, storming, normalising ­ before it can work effectively. U-care lacked the time to pass through these stages systematically. We have learned from these early mistakes, the team has taken a step back and has now formed, stormed and normalised to function brilliantly achieving its goals.

Each director except myself works three-quarters to full-time outside U-Care, so I oversee and co-ordinate operations.

U-Care offers consultancy services to PCTs, small practices, practices in difficulty, general medical and nursing services (general and enhanced), and education and support to patients, staff and other professionals (medical and non-medical). The group maintains high clinical standards in line with the new GMS contract and works hard to raise all of our practices and other contracts up to that standard ­ as a minimum.

We have been invited to talk to local authority staff about handling clients with a mental illness, and have had great interest in management training from junior doctors looking to combine medicine and management.

Our services will be useful to practices hoping to improve performance and QOF points in the coming year. At U-Care we

believe that all practitioners should have some business knowledge to survive these turbulent times.

Support for start-ups

U-Care has been fortunate enough not to require external funding. However, funding and support is available for start-ups. It helps to have a good relationship with your bank manager, and an accountant with know-ledge of business management.

We found our accountant to be an invaluable resource for business queries, as the firm had access to tax specialists and experience in setting up new companies.

As APMS is a relatively new concept, our local LMC was able to resolve contract issues for us.

The U-Care experience has been a positive one for me. I have learned a lot from my colleagues and continue to learn all the time.

Useful websites:

More information:


Useful books:

Pulse Management section, Medeconomics, free HSBC business package and CDRom.

Five Key Points:

· Take the time to choose and develop your team

· Ensure all team members share the same company philosophy

· Focus efforts on your goals ­ this improves productivity

· Make maximum use of team members' strengths and reduce their weaknesses

· Network with your potential suppliers and your competitors

· Keep costs to a minimum

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