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At the heart of general practice since 1960

New manager is pregnant

Three GPs share their approach to a practice conundrum

Having had four months without a practice manager, all the partners were very relieved when they were able to appoint her successor, an able woman with excellent references who could start within a month.

Although the place has ticked over, it has meant a lot of extra work for the partners – and extra accountancy bills as the previous practice manager delegated very little, and no one knew how to do all her jobs. The result has been that only the essentials have been done, and many of the audits, appraisals and so on are well overdue.

On her third day the new manager tells you she is four months pregnant and intends to take her full quota of maternity leave. The partners are deeply worried about the consequences.

Dr Des Spence

'Support her and hopefully she will repay you in loyalty'

All small businesses are greatly affected when key staff are absent, even for short periods. This is the case with maternity leave, especially with so many important employees in general practice being female. In this situation the practice may feel angry. No doubt someone (usually one of the other women) will suggest firing the new practice manager. Be very careful!

My advice with staffing problems is to say nothing until you get the correct information. Resist the temptation to let off steam, otherwise you might find you receive a sicknote from a neighbouring GP signing her off for 'work-related stress'. This could easily lead to a constructive dismissal claim. Remember that the practice manager is human and has every right to fall pregnant. Treating staff well when they are at their most vulnerable engenders a good team spirit and makes staff loyal. More importantly – and quite rightly – the new legislation will hang, draw and quarter you in an employment tribunal if you don't.

Your practice manager has legal rights from day one of her employment so you have to just accept this. Support her and be reassuring. Suggest she starts planning for maternity leave fairly soon. She should set up new systems that will run while she is away, start delegating tasks and train a deputy.

Should she return after her pregnancy she will hopefully be grateful for the support she was given. If she is able and hardworking the practice can afford to be flexible and should take a long-term view.

Des Spence is a full-time GP in Glasgow and also works as a tutor in general practice at the University of Glasgow – he completed the VTS in 1995

Dr Jason Twinn

'She's still an investment for the future of the practice'

Of course the new practice manager was perfectly within her rights not to inform us of her pregnancy and I suspect there is little we could do about it even if we wanted to. It is hard not to be irritated when someone is sick or pregnant, not because you don't sympathise with their problems but because it means even more work.

But it does flag up deficiencies in the running of the practice. While it is laudable that all the partners took on more administrative tasks and ran the practice without a manager, it is neither rewarding nor a good use of our precious free time. So while I would be congratulating the practice manager, I would also be inquiring about her long-term plans. If she only plans to come back part-time maybe we could train the senior receptionist to take on more roles, or share the roles out among other staff. Even if the manager plans to come back full-time it would be useful to have another member of staff who can act in her absence. Good practice managers are hard to find and we need her more than she needs us, so while her pregnancy is inconvenient, it does give us time to train other staff to take on more of her role.

The new contract is likely to see many practices struggling to get managers with the ability and willingness to work harder so the partners can take home more pay after ticking all the boxes. The quality of person found in most practices is just not reflected in the pittance they are paid.

Dr Jason Twinn completed the VTS in 2001 and is embarking on a full-time locum career in Scotland

Dr Harry Brown

'She has the time to prepare systems for her absence'

Well let's get one thing out of the road straightaway; if you employ a woman or take on a female partner who is of reproductive age there is always the chance she could get pregnant. Everyone involved just has to accept this as a fact of life.

What may cause a little bit of upset is that there is a fair chance she knew she was pregnant when she applied. Should she have told you?

But she might have been thinking it would not do her job prospects much good to mention she was pregnant, even though to discriminate would breach legal guidelines.

However, it does make me wonder if she was 100 per cent honest with us during the interview, even though she was under no obligation to disclose the fact she was pregnant. What impact may this have on the team and how will this affect staff morale?

You have to be positive and back her because there is nothing else you can do. If she is really the person for the job, I suspect when she returns to work she will feel she owes the practice something.

As a short-term solution, approach the PCT and see if it will take a sympathetic approach. It may provide funding, ideas or even a temporary replacement.

In addition, when the time comes for maternity leave, share out the workload of the practice manager between non-clinical staff and the doctors. Ask your accountants what they suggest, and even advertise for temporary help.

There is no point getting upset about this; the new practice manager has not done anything illegal and remember she is only four months pregnant. She still has plenty of time to catch up on the backlog, and set up systems to cope with her absence.

If this is well organised you will realise you have appointed the right person and hopefully when she returns she will pick up from where she left off.

Harry Brown finished the VTS in 1987 and is a partner and GP trainer in Leeds

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