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Investing in general practice
February 2003
Annex C: Competency framework for practice management
1. Practice Operation & Development
| Range | Administrative Role | Managerial Role | Strategic Role |
| PHCT Meetings | Will participate in meetings and possibly take responsibility for implementing action agreed | Will coordinate meeting programme, may chair and will undertake active management of meeting programme and sub-groups | Adopts a strategic approach, convening meetings and reviewing effectiveness and structure. May adopt advisory role. |
| Development plans/reports | Will provide data for planning/reporting and possibly assist in report production | Coordinates production and reviews consistency with external targets/strategy. May initiate remedial action | Will participate in policy sub-groups. May take responsibility for co-production and review of contribution to targets |
| Clinical services | Will provide data for planning and may assist in service needs assessment | Reviews service provision/ recommends change. May regularly review and implement developments or service extension | Will take responsibility for appropriate service provision and may advise on appropriate provision and development |
| Care pathways | Understands the principles of care pathways and participates in pathway mapping/design | Coordinates care pathway mapping/design/ redesign processes. May take responsibility for implementation and review of agreed pathways | Initiates pathway mapping/design, reviews and evaluates effectiveness. May advise practices on principles of pathway design and facilitate process |
| Liaison with secondary/tertiary care providers | Coordinates effective messaging systems. May provide data to assist problem-solving or service development | Reviews and facilitates effective liaison, acting as focal point of contact in GPs absence. May initiate dialogue to improve effectiveness of communication | Identifies interface problems and initiates dialogue to resolve. Actively manages dissemination of practice information and secures effective relationships. May advise practices on strategies for management of secondary/tertiary care interface |
| Strategy formulation | Will provide data for strategic planning and may assist in review/analysis process | Coordinates strategic process and may also collaborate with GPs in management process | Takes responsibility for identification of need for review, manages process and may identify need for strategy and facilitate its formulation |
| Innovation | May provide data to assist in study of feasibility of innovative ideas. Takes part in quality/innovation meetings | Will assist in feasibility study process. May contribute to development of new services or alternative means of delivery. Coordinates innovation meetings/process | Will undertake feasibility study/test viability of innovation. May have capacity to innovate and disseminate new approaches/perspectives |
| Clinical audit | Provides data for audit and may participate in planning audit and organisation of data | Will coordinate process directed by CG lead and may collaborate on CG, review and disseminate audit results | Leads audit process, taking responsibility for cycle completion. May advise others on audit structure/ format |
1. Practice Operation and Development continued
| Range | Administrative Role | Managerial Role | Strategic Role |
| Organisational audit | Will provide data for and may assist in organising data and in process planning | Coordinates process directed by GPs. May lead process or take responsibility for cycle completion | Will actively participate in policy development. May advise on structure/ format of organisational audit |
| Clinical effectiveness (CE)/ evidence-based practice (EBP) | Has an awareness of issues and language only | Will ensure compliance with local CE plans, putting systems in place and generating data. May also contribute to practice CE strategy | Ensures systems in place to evaluate CE. May assist with processes for CE and EBP |
| Resource allocation | Awareness of principles of equity and effectiveness | Reviews available resources against competing demands, reports and suggests options. May assess relative merits of competing demands making evidence-based recommendations | Undertakes systematic review of resource allocation, implementing changes as appropriate to maximise quality and effectiveness of services. May advise practices on evaluation techniques/strategies |
| Professional development | Is aware of CPD issues/language and has a commitment to training/development | Evaluates training and development needs of non-clinical staff. May coordinate professional re-accreditation and management of research | Sets standards for all non-clinical and clinical staff, ensuring the compliance of employed clinical staff. Monitors compliance of partners reporting exceptions to the partnership. May advise on CPD for all personnel in line with local and national policy requirements |
| Research | May gather/collate data for practice-based research | Is aware of the principles of models of organisational research, and participates in these. May coordinate participatory research projects taking responsibility for completion | Engages in and actively promotes theoretical and action-based research strategies, using these to improve understanding and effectiveness of organisational performance and management practice. May advise practices on research strategies to facilitate organisational development and change |
2. Risk Management
| Range | Administrative Role | Managerial Role | Strategic Role |
| Health and safety | Is aware of policy/operates procedures. May ensure basic systems are in place | Develops H&SW policy, ensures compliance with statutory requirements. May also develop or implement effective policy, and lead on H&SW | Will develop/implement effective policy, leading on H&SW issues. May also advise on appropriate policy and procedures |
| Fire safety | Is aware of policy/operates fire safety procedures and system checks. May ensure basic systems are in place | Develops fire safety procedures, liaising with professional advisors as appropriate. Ensures compliance with statutory requirements and maintenance of detection/fire fighting equipment. May also develop or implement effective policy, and lead on fire safety issues | Develops/implements/manages effective policy, leads on fire safety issues and makes recommendations regarding appropriate systems and equipment. May also advise on appropriate policy and procedures |
| Risk assessment | May assist in identification of potential workplace hazards and participates in risk assessment process | Coordinates risk assessment, ensuring compliance with statutory requirements. May take responsibility for recommending or implementing action to minimise workplace and public area risk | Leads on risk assessment, manages assessment process, monitors and reviews effectiveness of changes implemented. May advise practices on risk management process, policies and strategy |
| Significant event audit/reporting | Will participate in SEA systems and contribute to audit of events where appropriate | Coordinates SEA audit and reporting process. May undertake responsibility for reporting and implementation/evaluation of remedial action where appropriate, ensuring cycle completion | Instigates and manages SEA activity, implementing effective policy and pathway for identification and reporting of events. May advise practices on SEA process and facilitate staff and appropriate management training |
| Infection control | May collate relevant information | Coordinates infection control activity with lead clinician, equipment maintenance and periodic audit. May collaborate with clinicians in the production of appropriate policies, review of procedures and implementation of remedial action | Initiates and reviews policy development and manages process. Monitors and evaluates effectiveness of policy with clinical support, recommending changes where appropriate and overseeing remedial action. May undertake to advise practices on infection control policy and systems |
| Confidentiality | Is aware of policy and legal requirements and participates in activities to safeguard confidentiality. May take responsibility for training junior staff | Takes responsibility for coordination of procedures to safeguard confidentiality and ensures compliance with statute and other guidelines. Monitors effectiveness of procedures and reports breaches/ potential for breach. May investigate breaches and implement remedial action and undertake staff training | Develops robust policies and procedures. Monitors, reviews, and identifies deficiencies in procedures and implements remedial action. Anticipates changes to procedures in light of changing legislation. May take responsibility for advising practices on appropriate policy development and procedures, facilitating the availability of training |
2. Risk Management continued
| Range | Administrative Role | Managerial Role | Strategic Role |
| Ethics | Awareness of issues and requirements of ethical practice. May take responsibility for dissemination of practice policy to junior staff and undertake training | Coordinates policy and procedures relating to ethics, ensuring compliance with statutory requirements and appropriate staff training. May develop policies and monitor/evaluate effectiveness | Initiates policy development to meet statutory and best practice requirements. Manages procedures, identifies and remedies deficiencies. May advise other practices on ethical issues and facilitate appropriate training |
| Occupational health | No involvement | Coordinates arrangements for occupational health to ensure compliance with statutory and local requirements | Will manage occupational health processes, making recommendations on appropriate arrangements/procedures as appropriate. May provide an advisory resource for other practices |
| Poor performance | Is aware of language and issues. Takes responsibility for identifying poor performance in junior staff for whom responsibility is held. May participates in appraisal/ mentoring/training processes to remedy | Coordinates arrangements for identification of poor performance. Takes action to address this amongst non-clinical staff and may, with GPs, be involved with clinical employees. May undertake non-clinical standard-setting and provide appropriate training/mentoring programmes | Develops, implements and manages systems for identification and remedy of poor performance and monitors/evaluate effectiveness of these. May advise practices on issues relating to poor performance and disseminates/facilitates availability of necessary skills |
| Disaster planning | Is aware of arrangements and may participate in implementation of these when necessary | Coordinates arrangements necessary to safeguard emergency services and business recovery following a major event. Undertakes staff training | Develops comprehensive plan for business recovery and continuity of service. Monitors changing needs and liaises with/communicates plan to relevant stakeholders. May advise on planning process and facilitate appropriate training. |
3. Partnership Issues
| Range | Administrative Role | Managerial Role | Strategic Role |
| GP time management | Monitors rotas, reporting potential problems identified. May be involved in drafting rotas | Will design rotas to optimise clinical time and assesses locum needs. May review clinical workload planning long-term availability | Evaluates availability against national targets and manages recruitment schemes. May advise on clinical staffing needs and schemes to optimise long term availability |
| Locums | Will support locum GPs in post | Liaises with GPs regarding need and coordinates process. May also take responsibility for identification of need, recruitment and selection | Will evaluate efficiency and effectiveness of locums in post, taking remedial action where appropriate. May also promote systems for appropriate locum use/integration |
| Partnership meetings | Has awareness of decisions, implementing action as directed. May receive and action minutes | Supports, participates and contributes to meetings. May undertake coordination and review of action | May vote on appropriate issues. May also advise on meeting format, taking responsibility. for action implementation |
| Partnership agreement | No involvement | Will be familiar with the terms of the agreement. May undertake to monitor compliance of practice systems | Liaises with solicitor in drafting/amending agreement. With professional advice, may draft agreement, monitoring changing requirements |
| Partnership changes | No involvement | Coordinates arrangements for the changes. May be involved in organising finances and liaison with external bodies | Will lead recruitment process, participating in interview and selection, and advising on potential problems. May also coordinate process and advise on statutory requirements and partnership options |
| Taxation | No involvement | Will liaise with accountant and arrange prompt payment. May undertake payment planning and to ensure compliance with legal requirements | May provide general taxation and tax planning advice |
| CPD requirements | May take responsibility for administration of PGEA claims for partnership [NB: There will be no PGEA from 1 April 2004] | Monitors compliance and undertakes periodic reporting of partners’ status against requirements | Facilitates appropriate CPD by establishing organisational development needs and links individual development to planned practice development. |
4. Patient and Community Services
| Range | Administrative Role | Managerial Role | Strategic Role |
| Reception | Will supervise staff, and take responsibility for their work plans and may coordinate reception services | Manages all staff and services. May be involved in evaluation/ensuring service complies with best practice guidance and standards | May advise on structure, resourcing, extended services and training needs, ensuring appropriate availability of training |
| Information | Disseminates patient information. May also participate in production/updating of patient materials | Will review, plan, and market patient information. May have involvement in monitoring effectiveness of information and Practice image | May advise practices on appropriate marketing and communication strategy |
| Clinics/health promotion | Coordinates junior and administrative support for services. May be involved in maintaining data recording systems | Reviews and updates systems and services as needed. May undertake needs analysis, implementing and reviewing services in line with identified need | Plans/implements services to meet targets/NSFs (or equivalents). May advise on planning/implementation of services |
| Complaints | Will provide patients with information about Practice procedure. May also coordinate procedure for handling complaints | Undertakes drafting of procedure and management of process. May establish procedures to minimise complaints; monitors practice performance. Trains staff in practice complaints procedure | Will review, amend and evaluate performance. May advise on procedural requirements, staff training needs, and patient involvement |
| Community liaison | Is aware of community resources, disseminating information to patients. May also promote relationships with community groups and gather information. | Will encourage/oversee patient participation. May have involvement in establishing effective relationships with other stakeholders | Represents the practice and maintains the corporate knowledge base. May identify service gaps/deficiencies, advise on remedial action |
| Patient protection | Is aware of the language of patient protection and participates in patient protection guidelines and procedures | With lead clinicians, undertakes drafting of child and vulnerable adult protection procedures and participates in team process. May coordinate and manage procedures to ensure effective operation; monitors practice performance | Undertakes to review, amend and evaluate procedures, securing effective liaison with all other agencies. May advise on procedural requirements, staff training needs, and patient involvement |
| Community nursing | Establishes effective relationships between junior staff and community nurses to secure channels of communication. May coordinate messaging systems | Manages communications, ensuring effective exchange of information. May coordinate activities of integrated nursing team, meetings and joint/multi-disciplinary training | Participates in skill mix review of practice and community nursing teams. May advise practices on systems for coordination of nursing activities. |
| Social services | Establishes effective relationships between the practice and social care agencies to secure channels of communication. May coordinate messaging systems | Manages communications, ensuring effective exchange of information. May coordinate joint meetings and multi-disciplinary training | Participates in social care needs assessment of practice population. May advise practices on strategies for integration of health and social care |
4. Patient and Community Services continued
| Range | Administrative Role | Managerial Role | Strategic Role |
| Working partnership | Maintain effective working relationships with external NHS organisations (eg PCO, StHA (or equivalent) etc) | Oversees working relationships with external organisations. May have involvement in establishing effective working relationships | Represents the practice in developing relationships, identifying gaps and advising on remedial action |
| Networking with colleagues from other practices | Maintains effective working relationships | Oversees working relationships and may have involvement in establishing these | Represents the practice in developing relationships, identifying gaps and taking remedial action |
5. Finance
| Range | Administrative Role | Managerial Role | Strategic Role |
| Petty cash | Monitors expenditure. May operate systems and be responsible for authorisation of expenditure | Will instigate appropriate systems and monitor transactions. May establish/maintain accurate records /systems | Sets annual budgets and manage expenditure. May advise on design and implementation of systems |
| Payroll and pensions | Provides information for effective operation of systems and reimbursement claims. May also collate information and process payroll under supervision | Operates all systems within statutory/regulatory parameters. May also establish processes and ensure financial /security controls | May advise practices on appropriate systems and undertake staff training in systems management |
| Invoice payment | May monitor invoice receipt and payment process | Undertakes settlement of accounts with GP direction. May sign cheques etc within authorised limits | May advise practices on payment systems, record keeping and cost-effectiveness issues |
| Insurance | May monitor insurances and ensure cover remains in-date | Will review insurances and practice’s cover needs on regular basis | May advise practices on range of insurance options, suitability and resource effectiveness |
| Monthly accounting | May have supervised involvement in maintaining appropriate records | Ensures reconciliation of monthly accounts and appropriate financial controls. May establish accounting systems and undertake reporting | May advise practices on structure/format of accounting processes, appropriate systems and undertake staff training in systems management |
| Annual accounts | May be involved in collation of information to facilitate preparation of accounts | Prepares documentation collaborating with accountant. May also prepare draft accounts | Has the ability to prepare accounts to trial balance ready for audit. May also advise practices on preparation of accounts |
| Claims/targets/ quality payments | Provides data to enable maximisation of income. May also maintain claim/payment monitoring systems | Establishes appropriate systems and monitors targets, identifying income generation opportunities and reporting under-performance. May also institute remedial action | May advise practices on claims procedures, income generation, and provide appropriate staff training |
| Drawings | No involvement | Calculates and arranges payment under supervision. May undertake without supervision in accordance with partnership agreement | Will seek independent advice and provide drawings forecast. May also facilitate independent advice and advise on drawings management |
| Quarterly statements | May have some involvement in reconciliation, identification and remedial action where anomalies are identified | Will reconcile all statements, providing analysis and taking action on inconsistencies. May also implement remedial action plans for underperformance | Undertakes comparison of performance against national data. May advise practices on income, staff training and recommend remedial plans |
| Bank and accountant | No involvement | Acts as first point of contact with the practice. May also update /review development of financial systems and services | Negotiates/evaluates terms with financial institutions. May provide general advice about financial institutions and facilitate negotiations |
5. Finance continued
| Range | Administrative Role | Managerial Role | Strategic Role |
| Cash flow/budgets | No involvement | Collates and provides data to support systems. May also provide annual budget and forecasts with accountant | Will prepare, present and manage projections. May also advise on appropriate systems and procedures |
| Staff funding | May have involvement in the reimbursement claims process (2003/04). No involvement (2004/05 onwards) | Will operate devolved budget under GP direction. May undertake without supervision and advise on budget changes | Undertakes full responsibility for staffing budget. May also advise on resource allocation |
| Planning information | May provide or collate data as required | Undertakes regular reporting, recommendations on feasibility and supporting financial data. May also recommend development of service/assets | Will initiate and manage service/asset development. May advise on appropriate supporting information systems and development planning |
| Service budgets | No involvement | Will operate and monitor notional or devolved budgets under GP direction. May undertake without supervision and negotiate budget changes | Undertakes full responsibility for service budgets ensuring probity and effectiveness of deployment. May advise practices on resource allocation, providing/facilitating appropriate management skills training |
| Deficiency register | No involvement | With GPs, identifies/monitors and reports service deficiencies. May undertake planning for deployment of future resources to meet deficiencies identified. | Establishes, maintains and monitors prioritised deficiency register. May advise practices on deficiency register systems to support effective investment of new resources |
| Resource negotiation | May negotiate financial resources to develop/extend administrative/support services | Reviews practice resources, reports and makes recommendations as appropriate. May negotiate additional resources with partnership or PCO to meet identified need | Undertakes development of business case to support resource negotiation process with resource holders. May advise practices on information systems to support case and facilitate availability of appropriate skills |
6. Human Resources
| Range | Administrative Role | Managerial Role | Strategic Role |
| Staff management | Has delegated responsibility for management of junior staff. May hold responsibility for all ancillary staff | Holds responsibility for deputy/asst manager and other staff below that level. May be responsible for all practice employees | Undertakes autonomous management of all clinical and non-clinical staff. May provide relevant personnel management information and advice |
| Staff meetings | Coordinates and attends, chairs, minutes and actions outcome. May also initiate action following from meetings as appropriate | Will monitor action taken and review effectiveness of general staff meetings. May monitor and evaluate effectiveness of consequent action | Promotes multi-disciplinary meetings between practice, attached and area personnel. May advise on structure and format of meetings |
| Rotas and work | Operates rota systems, identifying and reporting problems. May keep records, maintain/monitor rotas and work systems | Establishes rota systems and work patterns, evaluating effectiveness. May undertake detailed workload analysis | Undertakes skill mix review, implementing changes as necessary. May advise on workload planning and implementation of rotas |
| Recruitment and selection | Will participate in process. May act as panel member to interview junior staff | Organises recruitment process for junior/ administrative staff. May undertake coordination of recruitment process for all staff | Will manage recruitment process and workforce planning. May act as resource for planning procedures, forecasting, recruitment and selection |
| Induction and training | Identifies training and induction needs of junior staff. May devise induction and training programme. | Will identify needs for the whole practice and arrange all induction programmes. May forecast training needs and facilitate in-house training | Actively participates in local training projects. May commission/facilitate training or provide courses and advice |
| Employment practice | Has awareness of importance. May have limited involvement in monitoring policies against practice/external guidelines | Will have detailed, current knowledge of employment legislation and record keeping requirements. May also ensure practice policies/procedures comply with statutory requirements | Undertakes anticipatory action to ensure practice policies/procedures will conform to changing statutory requirements. May also advise on implementing good employment practice |
| Disciplinary and grievance | Will monitor time-keeping, absence etc. for junior staff. May operate procedures for junior staff | Ensures procedures are in place and their proper use. Will handle minor incidents in accordance with procedure. May manage procedures for all staff in conjunction with GPs | Manages procedures for all personnel liaising with partnership. May also advise on appropriate procedures and implementation |
| Performance review | Participates in mentoring procedures. May make some contribution to appraisal process | Coordinates staff appraisal process for non-clinical staff. May design appraisal systems for all personnel | Undertakes appraisal of all personnel, with GP for clinical staff. May also design, initiate and promote performance review policies and mentoring |
| Pastoral care | May provide pastoral support for junior staff | Is aware of individuals’ personal needs and provides pastoral support to minimise any adverse organisational impact | Develops communication channels which support an environment of honesty and openness in interpersonal relationships within the organisation and is proactive in intervention where individuals’ problems can be anticipated |
7. Premises and Equipment
| Range | Administrative Role | Managerial Role | Strategic Role |
| Supplies | Maintains/orders adequate supplies. May also undertake monitoring of stock control systems | Implements/reviews stock control systems. May act to maximise cash flow efficiency in relation to stock control | May advise on appropriate supplies systems and their monitoring/evaluation |
| Equipment | Monitors equipment and reports problems. May monitor maintenance schedules | Will organise maintenance schedules and recommend new purchases. May plan long-term replacement of major items, recommending purchase or lease | May advise on purchase/lease options and maintenance requirements |
| Facilities management and maintenance | Will report cleaning/maintenance problems. May organise services | Plans and monitors maintenance needs, liaising with landlords and contractors. Maximises effective use of facilities available | Plans long-term maintenance strategy. May advise on premises cleaning/maintenance issues. Monitors and manages asset value to avoid negative equity |
| Facilities provision | No involvement | With GPs, may explore options for PFI, cost/notional rent or NHS LIFT | Evaluates relative merits of competing options, makes recommendations on most appropriate option. Undertakes preliminary negotiations with developer/PCO. May advise practices on options available for premises provision |
| Security | Contributes ensuring security is effective. May also implement security systems or make any changes necessary to practice systems following changes in personnel | Will liaise with advisors, establish systems and ensure systematic testing. Develops appropriate policies. | May advise practices on security issues and appropriate systems. Anticipates changes necessary to practice systems following changes in personnel and assesses the effectiveness of these. |
| Project management (equipment/ premises) | Contributes as requested. May undertake information-gathering | Liaises with external professionals and coordinates management of projects. May lead on overseeing of project management | Will initiate and/or manage projects. May advise practices on project management and feasibility studies |
8. IM&T
| Range | Administrative Role | Managerial Role | Strategic Role |
| Patient records | Will organise flow of records and supervise data entry. May maintain records systems | Plans, implements and oversees information flow systems for practice. May also plan, implement and oversee changes to systems | May advise on record keeping systems, requirements, standards and best practice in line with changing requirements |
| Data management | Ensures appropriate data are recorded/ retrieved. May supervise administrative data entry or undertake/coordinate data retrieval/reporting | Undertakes/coordinates searches/reports. May also establish requirements for data retrieval, reporting, review and action. May provide training in data retrieval | Undertakes to ensure data integrity/consistency and coordinates clinical data entry. May advise practices on data entry and retrieval issues |
| Data security | Complies with, and monitors practice systems. May supervise systems | Initiates, develops and oversees appropriate systems. May review systems in line with statutory requirements | Monitors effectiveness of systems and initiates remedial action. Researches/anticipates changes and implements appropriate changes. May advise on data security and protection as per NHSnet guidelines |
| Data interpretation/ manipulation | May collate data in accessible format for use | Reviews and provides analysis of practice data against pre-determined format. May assist in assessment of and reporting on practice performance. | Provides in-depth analysis of data to undertake evaluation of competing models of service delivery. May advise practices on appropriate data systems/interpretation techniques or facilitate availability of required skills |
| Hardware maintenance | Reports problems. May organise servicing and maintenance schedules | Will negotiate service contracts. May forecast system upgrade needs | May advise on maintenance and service contracts and options. |
| GP links | Enters agreed data and supervises other staff. May undertake monitoring of accuracy of data input by staff | Will analyse and reconcile data output and undertake periodic reporting | May advise on set up/ maintenance of systems and associated staff training |
| Crisis management | Report problems as they occur. May be responsible for identifying potential problems | Undertakes problem solving and leads crisis resolution
May lead on anticipatory crisis prevention | Undertakes disaster planning to ensure system and data recovery with minimal loss of service. May advise on crisis prevention/recovery and assesses effectiveness of system safety/security |
| Project management | Gathers data. May take responsibility for identifying deficiencies in system and in contributing to project management of new systems | Will identify system requirements with local advisor. May investigate options for upgrade and/or new systems, undertaking feasibility study and recommendations | May advise on project management of new systems, including feasibility study of options and making recommendations with local IT advisor |
9. Population Care
| Range | Administrative Role | Managerial Role | Strategic Role |
| Health needs assessment | Provides data to support assessment process. May collate data in readiness for analysis | Will coordinate needs assessment process in collaboration with clinicians. May initiate assessment and manage multi-disciplinary process | Monitors demographic changes in conjunction with service provision review, recommending changes as appropriate. May implement programmes of anticipatory care in conjunction with clinicians |
| Service performance indicators | Will have an awareness of terminology. May gather/collate data to monitor performance | With GPs reviews performance against national and local benchmarks/standards. Disseminates results. May implement systems to support appropriate remedial action | Undertakes responsibility for interpretation of high-level indicators in assessment of practice performance, managing strategy for performance/quality improvement. May advise practices on information systems to support quality management and provide analytical skills resource |
| Strategic delivery planning | Will have an awareness of terminology. May gather/collate data to support strategic planning process | With GPs, coordinates integration of identified population need, targets and projected demographic change data in planning process. May take responsibility for managing plan development | Identifies and allocates/negotiates resources required to support strategic delivery. May advise practices on strategic planning process and supporting systems, facilitating availability/accessibility of appropriate skills |
| Service prioritisation | Will have an awareness of terminology. May gather/collate data to inform decision-making | Collaborates with clinicians in Identification of priorities and makes recommendations on resource allocation. Implements agreed priorities. May review priorities, and initiate/manage service prioritisation process. Coordinates partnership contribution to the local service commissioning process | Undertakes systematic review of priority services to assess efficiency/effectiveness, recommending change where appropriate. May advise practices on service prioritisation, congruence with national/local targets. Contributes to the commissioning process and monitors/evaluates the effectiveness of this in meeting the identified practice population needs. |
| Resource negotiation | May negotiate resources to develop/extend administrative/support services | Reviews resources necessary to support practice programme of care, reports and makes recommendations as appropriate. May initiate negotiations with PCO regarding identified need | Undertakes development of business case to support resource negotiation process with resource holders. May advise practices on information systems to support case and facilities availability of appropriate skills |