Mandekh is a consultant and trainer with background in capacity development, education and organizational change management in the humanitarian and primary care sectors.

Her strategic roles in NHS commissioning and strategy have afforded her the opportunity to work on exciting opportunities with NHS England, Health Education England and innovative practices. Mandekh places a clear and consistent focus on agency, ownership and sustainability. 

Gabby began working as a Practice Manager in the NHS in 2011 and has extensive experience in senior management and leadership roles in both the NHS and secondary education.

Having worked as a Practice Manager and consultant in GP practices of varying sizes, from small rural surgeries to large inner city practices, Gabby has also been involved in mergers and TUPE processes both in the NHS and in her previous role as a Business Manager in the education sector.


Heather’s first role in primary care saw her join a practice on the verge of bankruptcy as Business Manager and turn it into a financially viable practice. With over 15 years’ experience as a commercial/managing director, Heather joined the FPM team in 2015.

Heather works with GP practices to address issues around access, HR/staffing, mergers, CQC concerns, business planning and new build development. She also facilitates practice meetings which have included partnership succession, strategy and motivation for clinical and non-clinical staff.




"We couldn't recommend First Practice Management highly enough. They came into our practice which was in crisis and has somehow managed to show us a way through our problems. After going through our finances First Practice Management identified multiple unclaimed items, amounting to several thousand pounds, which has meant that despite the cost of the service and implementing suggested improvements in the equipment/software, the whole process has probably left us in profit overall."

- GP practice, North of England


"We have been delighted with the management consultancy service we have received from FPM. Ruth conducted a two day review of the whole Practice and team, and recommended a number of ways in which we could improve efficiency within the Practice. We are now in the process of recruiting a new Practice Manager and FPM have been instrumental in facilitating this and we look forward to completing the recruitment process with Ruth and her team."

- Dr Kevin Tipper, Chorley


"We recently had a 2 day assessment of our practice, specifically focussing upon the management. We have all found it hugely beneficial in highlighting areas for improvement. A fresh pair of eyes has been invaluable in identifying weaknesses in our structure, and also training needs for staff."

- Dr Jonathan Smith, South Hetton