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At the heart of general practice since 1960

Show leadership qualities to meet contract's challenges

Dr Sohail Butt starts a new series by stressing the crucial role of leadership in general practice

Developing good leaders within your practice team will be essential in helping you meet the challenge of the new contract, maximising quality points and improving patient care.

Leadership is a combination of skills and behaviour. The key aspects relevant to GPs looking to develop services in 2004 are:

lHaving a clear vision of where you want the practice to be in one, three and five years regarding quality of care

lBeing able to communicate

lBeing able to persuade colleagues to share your vision

lHaving good management skills to facilitate the changes in the areas of IT, delivery of care and practice learning

lBeing able to nurture and develop leadership talent in your practice.

Leadership needs to be encouraged within a range of people in the practice, including the senior/executive partner, the GP partners, the practice manager, the practice business manager and the nursing and administrative teams. The development of leaders of small teams to address each quality area will help achieve maximum points. And when we talk of leaders in the practice, remember we're not necessarily talking about GPs.

Are leaders born or made?

Most effective leaders start with some innate ability, and then develop additional capabilities through training and experience.

Most practices will have some individuals with the necessary qualities to develop into effective leaders, but some feel they need people with additional skills in this area and can recruit accordingly. The growing number of practices advertising for business and development managers with leadership skills reflects this activity.

How do partnerships currently

deal with leadership

Many partnerships currently operate a system akin to a leaderless democracy, where each partner has an equal voice. This is a good system for producing team unity but it can make for ineffective decision-making and lack of focus and direction in practice development.

The executive partner is another role to consider. Accountants and solicitors have worked in partnerships with an executive partner role for some time. The executive partner co-ordinates the management responsibilities of the other partners, chairs meetings and supervises the work of the management staff. Some GPs have developed an executive partner role and others have made their practice manager, who has a leadership role, into a partner. There is anecdotal evidence that practices with clearer leadership have been able to attract increased resources and achieve better quality markers.

How do you start to develop leadership within your practice?

It is important for key members of the practice team to have time out of the usual busy practice working day to look at development issues.

A half-day away from the practice can allow ideas and leaders to emerge. A skilled facilitator, briefed on the issues, can be invaluable. Some of the following issues may be helpful to look at:

lCurrent issues and concerns within the practice

lHow the practice currently makes decisions

lHow people would like to see the practice develop

lHow well the practice is currently managed and led

lHow clinical and management responsibilities are currently allocated.

If people take on new leadership roles it is important that some consideration is given to providing mentoring, support and training for these individuals.

Who can help you develop leadership within your practice?

The PCO The PCO may be helpful in providing financial support for meetings and providing skilled facilitators with experience in this area. PCOs have a real interest in seeing practices develop good leadership and deliver good quality of care.

NHS Modernisation Agency The NHS Modernisation Agency has resources and a programme of activity aimed at developing NHS leadership to improve quality of care. www.primarycare.nhs.uk/developing_people.html#a

How to develop leaders in your practice

lIdentify potential talent

lProvide initial training

lPut the right people in the right positions

lGive 'leaders' regular time out to plan the future of the practice

lMaintain training on an ongoing basis

lExploit appropriate training facilities (eg PCOs or the NHS Modernisation Agency.)

Sohail Butt is a GP in Ashford, Middlesex, and has an interest in practice development

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