Table Of ContentThe Practice Mana
THIRD EDITION
Edited by
Michael Drury
AND
Lynne Hobden-Clarke
RADCLIFFE MEDICAL PRESS
OXFORD and NEW YORK
© 1994 Radcliffe Medical Press Ltd
15 Kings Meadow, Ferry Hinksey Road, Oxford OX2 ODP
141 Fifth Avenue, New York, NY 10010, USA
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, electronic,
mechanical, photocoping, recording or otherwise without the prior permission
of the copyright owner.
First Edition 1990
Reprinted 1990
Reprinted 1991
Second Edition 1991
Reprinted 1992
Reprinted 1993
British Library Cataloguing in Publication Data
A catalogue record is available from the British Library
ISBN 1 85775 050 0
Typeset by AMA Graphics Ltd, Preston
Printed and bound in Great Britain by
Biddies Ltd, Guildford and King's Lynn
Contents
Preface to the First Edition v
Preface to the Second Edition vii
Preface to the Third Edition ix
Publisher's Note ix
List of Authors xi
1 The Nature and Structure of General Practice 1
Michael Drury
2 The Nature of Management and Administration 10
Roderick Martin
3 The Role of the Practice Manager 26
Ly nne Hob den-Clarke
4 The Personnel Management of the Team 45
Ly nne Hob den-Clarke
5 Training and the Primary Care Team 73
Bernard Baillon
6 Communication 87
Paula Taft
7 Computers and General Practice 101
Angela Scott
iv THE PRACTICE MANAGER
8 Managing Audit 128
Michael Drury and Sue Casement
9 Managing Money 136
John Dean
10 Fundholding 183
Lynne Hobden-Clarke
Total Fundholding 204
Richard Wilkinson
11 Managing Patients 207
Bernard Baillon
12 Managing Prescribing 220
Christopher Trower
13 Health and Safety 226
Norman Ellis
14 Managing for Quality Care 240
Michael Drury and Lynne Hobden-Clarke
Index 248
Preface to the First Edition
THIS book is written for the practice managers and senior receptionists. Whilst
it will stand on its own, it is designed to accompany Practice Manager
Development, a course in which a group of practice managers (and sometimes
doctors) learn together and from each other. Whilst nearly all group practices
now have a practice manager their experience and skills are very varied.
Some, probably the majority, have been promoted within the practice from
receptionist and have learnt and developed as time has passed. These have
very often had little opportunity to learn outside the practice, little chance to
get support and education from their peer group and it has been difficult to
introduce modern management skills from different business areas. A few
have come from outside with previous management training but have had to
learn the medical component of their job the hard way. This book is designed
primarily for the former group but we hope that any practice manager would
be helped by it.
The authors have been drawn from outside disciplines and from the
medical world in an attempt to get the balance right; the book therefore covers
both concepts and practical issues. Managers are concerned with people,
equipment and money and the management of all these aspects of general
practice is considered.
Not all practice managers are female but for the sake of continuity we have
written as if they are and as if the doctors are male. We hope this device will
not offend others.
We are grateful to Drs Fleming, Oldroyd, Ridsdill-Smith, Taylor, Pike and
Steel who, sometimes with their practice managers, advised on the content
of the book. We are also grateful to a large number of secretaries who have
helped. Finally, our thanks go to Andrew Bax and Kate Martin at Radcliffe
Medical Press and to Ciba-Geigy Pharmaceuticals whose financial help made
publication possible.
Professor Sir Michael Drury
Department of General Practice
University of Birmingham
November 1989
Preface to the Second Edition
THE wide acceptance of the first edition of this book has been responsible for
the need to reprint it during its first year. Further demand has given an
opportunity to produce a Second Edition and to add some new sections,
keeping it thoroughly up to date with the rapid changes in the health service.
In particular, sections have been added to cover audit, practice prescribing
budgets and fund holding. We have also taken the opportunity to make
alterations to those sections covering communication, motivation and team
work as well as revising most other chapters. All concerned in this new edition
recognize the importance of the role of practice managers in today's health
service and hope that this book will help them with their tasks and add to
the satisfaction they obtain.
I would like to acknowledge the help of David Clegg and Michael
Hamilton, who have joined our team of contributors for this edition, and of
Janice Downing and Pauline Shepherd, who advised in its preparation.
Professor Sir Michael Drury
Department of General Practice
University of Birmingham
May 1991
Preface to the Third Edition
Despite the popularity of the first two editions of this book the rapidity of
change in general practice has meant that a third edition is required, only
four years after its first appearance, to ensure that it is thoroughly up-to-date.
We have made radical changes, including enlisting more practice managers
as contributors, who now provide almost half the content, and sharing the
task of editing. Computing now merits a separate chapter and the chapter on
fundholding has been revised and expanded. Issues of quality are dealt with
in the sections on audit and in the final chapter.
We are grateful for the enthusiastic support of contributing authors and
to the editorial staff at Radcliffe Medical Press. Finally, we are aware that
the pace of change is unlikely to slacken and would therefore welcome any
suggestions from our readers on how this book may be further improved.
Sir Michael Drury,
Emeritus Professor of General Practice,
University of Birmingham
Mrs Lynne Hobden-Clarke,
Practice Manager,
Gerrards Cross
Publisher's Note
Gender is an issue which always provokes controversy and comment, and
there is no successful formula which can avoid it. Readers of this book will
notice that some chapters are written as if all practice managers are female,
and others as if they are male. Although it would normally be part of our
editorial process to make the text consistent in such matters, we decided, on
this occasion, to leave it according to the contributors' style. This policy will
not satisfy the purists, and to them we can only apologize.
However, all of us know that practice managers can be of either sex, and
we ask those who use this book to read it with this reality in mind.
Radcliffe Medical Press
July 1994
