Leading practice-based commissioning
Sal Riding, Shropshire Primary Care Trust
Health Foundation Leadership Fellows
Sal Riding, Leadership Fellow
As the healthcare landscape continues to evolve, so too does the role of the GP. Recent policy initiatives, such as the inception of practice-based commissioning and the current focus on moving care closer to patients’ homes, have presented both opportunities and challenges for local practitioners as they strive to provide high quality care for their patients.
Dr Sal Riding, a GP in Shropshire and a Health Foundation Leadership Fellow, is involved in driving healthcare quality improvement in her area from the ‘bottom-up’. She has been elected practice-based commissioning lead in her county and is responsible for co-ordinating work between local practices as the system develops.
“I’ve taken the lead in Shropshire in encouraging GPs to take an active role in practice-based commissioning and have used my improved confidence to communicate more effectively with senior executives and other partners,” Sal explains. “I represent 46 practices within the county and am the point of contact for a number of bodies, such as the PCT, local hospital and even MPs.
“My function basically involves engaging GPs in practice-based commissioning and trying to help managers and clinicians work together more effectively to ensure that GPs are properly supported to make best use of the system.”
Participating in The Health Foundation’s Leadership Fellows scheme has made a significant difference to how Sal approached this task. “I have learnt a lot about myself, how I relate to others and motivating factors for other people,” she says. “As a result, I have changed the way in which I approach the job.”
“The Leadership Fellows scheme is a fantastic experience. It offers me invaluable personal support and encouragement. Coaching provides the opportunity to think through issues and upcoming challenges.”
Support structures
Sal has found the support she has received as part of the scheme to be invaluable. “As a GP, you don’t have the formal supportive structure of an organisation behind you and it’s sometimes easy to feel isolated,” she says. “So to have the opportunity for one-to-one coaching, and the time to reflect and consider different ways of removing the barriers, has been fantastic.”
Describing how she has benefited from the other aspects of the scheme, Sal says: “Background reading for seminars has enhanced my understanding of leadership skills and techniques and I’ve found the experience incredibly helpful in terms of understanding how health service management works.”
Sal is also using the skills she has developed through the scheme to assist others.
“I’ve begun mentoring two colleagues in the local PCT myself,” she explains. “They heard me talking about the benefits I’d experienced as a result of having my own mentor through the Leadership Fellows scheme and approached me as a result.
“We meet for a couple of hours each month,” Sal continues. “I think it’s really useful for everyone involved to share their experiences. As well as helping solve some of my colleagues’ problems, I can learn more about the PCT from them and they can hopefully learn more about practice-based commissioning from me!"
Making progress
While it is still too early to assess the impact that practice-based commissioning may have overall, Sal believes that tangible progress is being made in Shropshire and is optimistic about the potential for improving local services in the future.
“The process has got much, much stronger now,” she says. “Every practice bar one in the county is involved, and we’re arranged into five clusters of local practices with an individual Chair and Board for each cluster. Each group has got plans for moving forward and we’re working well with the PCT.”
“Practice-based commissioning is obviously new for everyone,” she continues. “There is no rule book or blueprint on how to do it successfully and, without some form of co-ordination, individual practices would have gone off and done their own thing. Instead, we’ve come up with a system involving around 60 doctors that allows us to find out what does and doesn’t work, and to share that learning.
“I think things look really promising at the moment,” Sal concludes.
23 May 2007
