Practice Management

Practice management is a broad and essential component of a successful career in general practice. Beyond clinical care, GPs are often involved in the day-to-day running and strategic direction of their practices. This chapter introduces key elements of practice management (including operational, financial, legal, and human resource considerations) to help trainees develop a foundational understanding of how general practices function. By exploring different practice models and management approaches, this chapter aims to equip trainees with the insight and confidence needed to contribute meaningfully to the effective running of a practice.  

• PT1. Apply national healthcare guidelines and policies to your practice, ensuring evidence-based and standardized care.
• PT2. Develop and implement procedures to mitigate risk, including critical incident analysis to improve patient safety.
• PT3. Construct and maintain a health and safety statement for the practice, ensuring compliance with legal and regulatory requirements.
• PT4. Implement robust measures to protect patient data, ensuring confidentiality and compliance with other data protection regulations.
• PT5. Manage financial aspects of primary care, including comprehensive processes to analyse and manage income streams, budgeting, taxation, financial control, and business planning.
• PT6. Understand the business aspects of primary care, such as contracts, human resources, and the practice's impact on the local community.
• PT7. Consider the role of GPs as employers, including staff development, performance management, recruitment, and compliance with employment laws.
• PT8. Explain key considerations regarding entry into general practice, including partnership negotiations, locum work, and assistantships.
• PT9. Manage access to GP Services effectively through appropriate appointment systems, efficient time management and safe out of hours care arrangements.
• PT10. Develop systems that enhance workflow processes while ensuring continuity of care.
• PT11. Promote ongoing education and training for all staff members to maintain and enhance their competencies, ensuring high-quality care delivery.
• PT12. Implement systems for planned patient care, such as call and recall programs for Chronic Disease Management, Prevention Programmes and Opportunistic Case Finding, leveraging technology and patient engagement strategies.
• PT13. Confidently and safely interpret, manage, and communicate normal and abnormal results, ensuring appropriate follow-up and adherence to evidence-based guidelines and medicolegal responsibility.
• PT14.Demonstrate understanding of how general practices manage patient complaints and medico legal correspondence.
• PT15.Demonstrate an understanding of clinical governance in general practice, including accountability structures, leadership roles, regulatory compliance and systems for oversight of documentation for policy and procedures and assurance of service delivery.

Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

Self-Directed

Blended Learning Resources (Education Platform)

Introduction to Practice Management

Introduction to Clinical Software in Practice

Introduction to Audit and Quality Improvement Methodologies in General Practice

Useful Websites:

Non clinical Update Irish College of GPs

Medisec GP Resources

BeSMART

Network of Establishing GPs

GP Practice Ally

IMO Contract Agreements

Workplace Based Learning

Practice management is most effectively learned during the Registrar years of GP training, when trainees have daily exposure to the inner workings of a general practice. Each practice operates slightly differently, and trainees may find themselves in a single-handed, rural, or large multi-GP setting; all of which provide valuable insights into varied practice structures and systems. Over the registrar years of training, trainees are encouraged to observe and engage with the operational side of the practice. Attending practice meetings offers a window into how decisions are made and changes implemented. Where there is a practice manager, scheduling a tutorial with them can be particularly informative - providing perspective on their role, day-to-day responsibilities, and how they manage the business side of care. Exploring how income is generated, understanding expenditure, and asking questions about financial and administrative processes will help trainees build the confidence and knowledge required for future roles in practice leadership and ownership.

Day Release

Practice management can be effectively learned during day release sessions through structured tutorials and peer discussions. These sessions provide a valuable platform for trainees from various practices to come together and share insights about how their individual practices are managed. This cross-practice exchange allows trainees to compare different systems and workflows, identify effective strategies, and reflect on areas for improvement. Engaging in these discussions not only broadens their understanding of diverse management styles but also encourages critical thinking and the application of best practices. Ultimately, day release becomes more than just academic learning - it becomes a collaborative space for professional growth in managing a clinical practice.

Registrar Tutorials

Practice management can be effectively learned during trainee/trainer tutorials by focusing on real-life examples and personalized feedback. These one-to-one sessions offer an ideal setting to explore the day-to-day running of a practice, such as appointment systems, staffing, finances, and leadership roles. Trainers can share their own experiences and guide trainees through challenges they may encounter, helping them build confidence and practical knowledge in managing a practice environment.

Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

EPA 18: Manage the GP practice and available resources

Taking the lead in reviewing and improving a recall system for chronic disease management provides a valuable opportunity to demonstrate EPA 18. For example, a trainee might analyse the practice’s call and recall processes for diabetes care, identify gaps in follow-up, and propose improvements leveraging technological solutions such as automated reminders or dashboards. A CBD tool can be used to record feedback following a discussion of this work during practice meetings. 

Core Knowledge Test (CKT)

• Knowing the services to GMS/DVC patients that are not covered by the capitation fee and are claimed through the special type consultation (STC) pathway.
• Choosing the most appropriate action when a patient requests a copy of their records under GDPR.
• Identifying the best approach to address repeated breaches of infection control policy by a staff member. 

Clinical Competency Test (CCT)

• A patient is called in to see you as part of the CDM programme and asks you to explain the programme to them, how it relates to their condition and the implications for them.
• A patient requests that you explain their scan results to them with the implications for their diagnosis, management and prognosis.
• A patient presents with a new diagnosis following a hospital admission and wishes you to explain the diagnosis, management and follow up.

Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.