How I changed career
A colleague of mine once told me that everyone should change their career at least once to bring a fresh pair of eyes into a new sector. After more than 20 years working in financial services, during which I qualified as a chartered accountant with Arthur Andersen and then worked at Chartered Trust and Lloyds TSB, I wanted to find a job where I could help others and make a real difference.
I went through a career advice programme where they looked at my values and what kind of sector would suit me best, and they came out with the charity sector and the NHS, which really coincided with my priorities. I decided to join the NHS in Wales as a practice manager. I was in my first role for five years and I have been with my current practice, Parc Canol Group, since 2013.
My typical day
Fortunately I don’t have to directly deal with all the operational issues of a local practice, but I do have to keep an eye on them, which could be anything from a leak in the roof, to a GP being off sick, managing patient concerns or keeping an eye on the bank balance – because we need to manage our own cashflow.
We don’t have a lot of internal meetings because our schedule is dictated by the fact that the GPs are working pretty much throughout the day. It’s actually a very difficult environment in which to manage a business. We can’t close the doors or turn our phones off. I spend most of my time in the office, but we have three different sites and I do go out to them, as well as attending meetings with other practices. Every day is different. There is no routine, which is good – it’s the last thing I would want.
The challenges I’ve overcome
Moving from the private to the public sector was a massive change in terms of the attitude and working ethos of some of the staff members. It’s also very different going from a large institution with thousands of employees to a very small one. I am part of a small organisation but I have to influence a wide range of external people and organisations, and this takes a certain skill set.
The NHS is extremely short of resources, so we are all asking for a share of a limited pot. My role also includes dealing with patient complaints, and some of them are really unhappy. In some cases, the reason for their unhappiness is the limit of our resources, which means we can’t provide the service they expect. The other side is that sometimes I am talking to patients who are pouring their hearts out thanking us for our help. It can be very emotional to hear these stories, and it’s definitely something I wouldn’t be exposed to in my previous roles.
When people have little knowledge of the National Health Service, they don’t see everything that goes on behind the scenes. I want to make the point that, even though we are part of the NHS, most practices are independent organisations. The GPs are partners and are contracted by the NHS. When you work at a practice, this can be quite an eye opener. Some GPs find it impossible to take holidays because they can’t find anyone to cover for them.
We’ve got doctors who are literally giving up their practices, handing the keys over to the board and walking away because they can’t cope any more. It’s horrendous. That said, one of the reasons for changing career was because I wanted to help others and I have definitely achieved that. I feel like I make a difference in this role and I can genuinely see the impact I have on patients.
A GP practice has to be run as a business with financial and profitability concern balanced against the need to provide services to our patients. We are masters of our own monies. Because I am managing a small business, my remit covers HR, finance, premises, IT, strategy, operational management, patient satisfaction, data protection and GDPR.
One of the things I have been most proud of recently is working with a neighbouring practice to put on an event for homeless people. They are a sector of the population that often falls between the cracks in terms of medical services because they don’t have a home address, somewhere a GP can visit them, or where we can send letters. Through this event, they can access several organisations to help them with whatever issues they are facing. Our work has come to the attention of the Welsh government, which has praised it.
The habits of an accountant
Being an accountant has stood me in very good stead. I know a lot of managers who are struggling with the current pace of change, but I have faced it all before. Taking care of the financial side of things doesn’t cause me any concern.
I know this element is a challenge and a barrier for some practice managers, which is partly why many more are now coming in from external organisations including the financial services sector. The job is also about understanding how a business works, knowing when you need advice or not, and being able to manage a team, all of which I have experienced before.
How the ACA helped my career
Managing a business is helped by my ACA training and my ability to take a broader overview and manage the business strategically, particularly now that I am working in an area with such a fast pace of change and where I need to take many commercial decisions. I also use my ACA skills to act as treasurer of the national charity Japanese Garden Society, which promotes Japanese culture and garden design.
I was looking for a new interest because I like to challenge myself and taking on a treasurer role was a natural step. I have an interest in gardening and the aesthetic side of Japanese gardens, so it looked to be a good match. Again, I think the financial and organisational skills I have as a result of my qualification have been a great benefit because I don’t just cover the finances, I am also involved in steering the strategy of the charity.