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Secret Diary of a Practice Manager: Taking a Forward View

Love them or loathe them, the Five Year Forward View (FYFV) and General Practice Forward View (GPFV) are here to stay and will continue to be rolled out whether we like it or not.

The plans give a blueprint for the changes in delivery of services provided by those of us working in primary care and other sectors of the NHS, bringing together all agencies within the health sector. The key aim of the Forward View plans is to shape services for the future. If we could disassociate ourselves from our positions, looking from the perspective of members of the public, would we not support such changes?

It is often said that ‘failing to plan is planning to fail’. The plans themselves have been met with a mixed response across the country and the progress of their implementation varies from region to region.

That in itself is very revealing, as each CCG is being encouraged to work on its own individual plans that take into account the individual needs of its patients. This makes so much more sense than saying ‘one size fits all’. Of course we all have a choice as providers to either embrace the view or do nothing and take the consequences, which will probably mean having it forced upon us.

In my last role, the area where I worked had federated, and practices were beginning to work together and the patients definitely benefited from the actions being taken. Don’t get me wrong - there were problems in the workings, but the desire was there and good communication meant the problems were overcome.

We had appointments available at hubs weekdays till 8pm and weekends. The weekends were not a success, despite patients saying that was what they wanted. At least we had tried though, and ticked a box within the forward plan.

After moving roles, I was somewhat surprised that within my new area nothing had really been done to work together and tackle the Forward View ideology. I did quite a bit of research and only then realised that progress across the country was very patchy. What’s more, there were areas where there were sceptics who were suspicious of the new plans and were doubtful that the initiative would work, without even giving it a chance.

Over the last few months we have tried entering into discussions with other local practices to try to work out how we can deliver the changes being asked of us, that will not only benefit our patients, but help in the day-to-day workings of busy practices.

There is a recognition that things need to change but there also appears to be a worry about working with others and what that may mean. Will we lose our independence? Will we be able to work together? How will we work it out financially?

There does seem to be a lot of negativity, whereas the surgery where I work is far more open to changes and accepts that embracing collaborative working on a voluntarily basis is better than having it forced upon us.

In my area we have recently all met up, partners and practice managers, and had various presentations from accountants, our LMC and people who have already started on this road with their experience. It was extremely illuminating and the hope that others could see opportunities were not met as I would have hoped.

So, as I write this we are no further forward in being able to deliver the Forward View as a group, however we will continue the dialogue with our neighbouring practices and hope that somewhere, somehow, we will come together otherwise the choices we have now will be replaced with a forced change.

So, I end the blog as I started - with a reminder that “failing to plan is planning to fail”.

Look out for further coverage of the GP Forward View in the FPM Blog next week, when we take a look at what progress has been made one year in to the initiative.


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