Best practice: One practice manager’s journey to delivering better care


There are a variety of reasons that people enter the healthcare sector; for Ann Neville, practice business manager of Darwen Healthcare, Darwen, it was to make a difference – to deliver quality care for patients. This is exactly what she does every day in her practice and beyond, and she has been recognised for this at the prestigious General Practice Awards

Every year the General Practice Awards recognise and reward the hard work and innovation that happens in practices across the UK. Ann Neville, practice business manager of Darwen Healthcare, was awarded Practice Manager of the Year 2017; one year on she is still leading the Darwen Healthcare team to deliver better care.

Ann’s Practice Manager of the Year Award recognised her for the development of effective systems and processes to ensure safer working and for being focused on the personal and professional development of her team – supporting them to innovate practice; she continues to ensure the delivery of outstanding healthcare. We had the opportunity to catch up with Ann and learn about how she entered the profession to improve it, and how she continues to do that.

To get the ball rolling, tell me a little bit about yourself and Darwen Healthcare

I initially spent 18 years working within the travel industry at management level – building teams and communicating on a daily basis with the general public were key to that role. When my father was diagnosed with multi-infarct dementia I wanted to spend quality time with him whilst he was still able to recognise me and gave up working full time.

Due to some of the difficulties I faced accessing information relating to his diagnosis I took a decision that I would embark on a career in the NHS and hoped, one day, to make some sort of a difference. I worked in several areas – GP practice, physiotherapy, cancer services and the East Lancashire hospice and it was at the hospice that I really learned about the quality of care for patients.

I began my employment at Darwen Healthcare in August 2013 as a customer service manager and became practice manager in December 2014.

Darwen Healthcare is a GMS practice with a growing list size – currently at just over 12,500 patients. We are located in a purpose-built health centre with a multitude of services within the building such as treatment room services, district nurses, dental, podiatry, MSK, audiology and a community pharmacist.

You are the 2017 Practice Manager of the Year; what was it like to be nominated and selected as the winner?

I was nominated by Dr Penny Morris, GP partner at the practice (she had also nominated me in 2016 when I also made it as a shortlisted finalist!) Unfortunately, due to a relative being very poorly, I was unable to attend the awards ceremony and was hugely shocked when I was selected as the winner. I felt honoured to have been nominated and shortlisted in the first place, and then absolutely delighted to have been selected as the winner of this award.

I have to say that, without the support of the whole practice team – GP partners, GPs, trainees, advanced nurse practitioners, practice nurses, assistant practitioner, healthcare assistants, administration and reception staff – I would not be able to do the job that I do and, therefore, I felt that the award was for them as well. I also feel it is important to say how proud I am to work in general practice in Blackburn with Darwen and to be able to highlight the amazing work that gets completed daily in the GP practices within our area.

There were two areas that you were commended for in particular; one was that you developed and implemented processes to support safe working in Darwen Healthcare – what did you introduce, and why, and what were the outcomes achieved?

Most of the decisions made are generally patient-focused and innovative, such as ensuring that the practice learns from significant events or near misses and creating a number of quality check systems. I ensure that I listen to all practice staff, encouraging them to be proactive in patient care and to take ownership of their ideas; I welcome their suggestions on how we can improve as a practice. It is my job, then, to ensure that these ideas can be facilitated and to ensure that, operationally, their ideas become a reality.

For example, the nursing team, with administrative support, completed a project relating to pre-diabetes and saw the practice win the RCGP Bright Ideas Award for England 2017.

You have also worked to upskill and maximise the practice’s workforce. How did you introduce this and ensure that your whole team was on board?

I worked extensively, and I worked hard, to ensure that the practice has a robust appraisal process seeing staff receive a 360-degree feedback document so that the appraiser can hold a ‘meaningful’ appraisal rather than a ‘tick box’ exercise.

Staff have been keen to share their aspirations for the future which has given me the opportunity to upskill and maximise the contribution from staff – essentially, ‘growing our own team’. We have a GP partner and a salaried GP who both started off life in the practice as GPST3 trainees; a receptionist trained as a healthcare assistant, then qualified as an assistant practitioner, and is now looking to complete her pre-registration as a nurse. Non-clinical staff have also upskilled; for example, all receptionists are now ‘care navigators’ and one secretary has become the corporate governance administrative lead.

The practice team, and the mutual support it provides, is key at Darwen Healthcare – how do you keep the team motivated day-to-day?

Communication is key to keeping a team updated; regular emails, friends and family feedback and patient surveys all keep us updated as to what is going on in the practice. Team briefs are a great tool for ensuring that staff are congratulated when they go above and beyond and social events help us to get to know one another outside of work and we learn about each other. The practice team love to hear when patient outcomes have improved, or when projects have been successful, and these then become part of the daily life at Darwen Healthcare.

General practice is changing and this is reflected in the practice workforce which is becoming more multi-disciplinary. You recently welcomed your first physician to the practice – what led to this decision and, six months on, how is it working out for the practice and patients?

Darwen Healthcare is an established training practice that hosts a variety of trainees and student placements. We supported cohort 1 of physician associates from 2016 to 2018 and, during that time, we hosted placements for a number of physician associates.

We were fortunate to have a physician associate who was placed with us as a first placement and then came back to the practice to finish his last placement before qualifying. What we noticed was the huge learning curve that had taken place and we felt that there was a place in our practice for a physician associate. Six months on, he is doing really well; his day consists of administrative tasks, lab links, on-the-day minor illness clinic, home visits and he also has a frailty in-house clinic.

You have been commended for your hard work and innovative approach – what’s next for the practice?

We now have a clinical pharmacist and our paramedic practitioner is due to commence in post in early September; will see the practice ensuring that there is a holistic approach to care, including referrals to the integrated teams, to ensure that patients receive holistic care.

I am currently working with another practice manager in East Lancashire on developing the ‘Pennine Lancashire Enhanced Training Practice’; its main aims would, predominantly, be to continue to support and expand nursing student placements, to sign off mentors in general practice and to increase capacity over the next two years, utilising the experience, knowledge and skills of nurse mentors.

From a non-clinical aspect, we are working hard to increase the digital options for patients – such as online booking, online consultations and ensuring that our patient participation group is valued for the incredible work they do for the practice.

Any advice for other practice managers who are faced with current challenges?

I guess we all face different challenges due to a difference in patient populations. The advice I always try to follow is to ‘look outside of the box’ and to use your energy positively.

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