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Practice managers say they were more engaged under PBC

Practice managers say they feel less involved and valued in CCGs than they did under PBC, according to the NHS Alliance practice managers’ network.

 Caroline Kerby, co-lead for the NHS Alliance practice managers’ network, said practice managers needed to be the ‘custodians’ of PCT functions such as financial and risk management, innovation, organisational development and relationship management.

‘So when PCT managers switch out the lights and go home, the most stable form of management that will have the organisational memory is likely to be in the practices and it’s essential that is kept in the mix alongside the new managers that are in the system and will be needed.’ Ms Kerby told a NHS Alliance commissioning event in Manchester today.

 In July, the NHS Alliance held four regional events and spoke to 350 managers. Ms Kerby said there were ‘some very common themes. In some areas they recognise the value practice managers have and in some areas they’re being positively excluded. In some areas that was down to the PCT and in some areas felt to be down to the clinical people involved. Certainly there was a shift from PBC and the involvement of practice managers into clinical commissioning. The practice managers felt far less engaged and valued under clinical commissioning than they had under PBC.’

The NHS Alliance has written to clinical commissioning network lead for the Department of Health, Dr James Kingsland to say practice managers feel they have something to offer. ‘We have said that clinical commissioning will be poorer if we’re not used’ said Ms Kerby.

A clause in the Health and Social Care bill states that the clinical representative from the practice must have a clinical qualification.

NHSAlliance executive member, Dr David Jenner, said: ‘The consequence of this is GPs can’t delegate this to the practice manager, but they could to a nurse.’

In a interview with Practical Commissioning, Ms Kerby, said under PBC, practice managers were accepted onto clinical leadership programmes ‘There was an acceptance (by the DH) that because of our frontline work with clinicians and patients that there was a value to practice managers being developed as clinical leaders. That seems to be less so under clinical commissioning.

She added: ‘Talking to people on boards, certainly a few have had to fight for their position to stay on the board.’

Amanda Sayer: patient and public involvement lead for the CCHC CCG in East Sussex and a practice manager in Eastbourne: said ‘Lots of managers in our area were involved in PBC and most consortia had a practice management group that sat in on board meetings but now it’s much, much less. There’s a huge disengagement.’