A Day In The Life...

Rachel Vial, Practice Manager and Business Partner

Quite coincidentally, the day I interviewed Rachel was the 20th anniversary of her joining Shipston Medical Centre (SMC) as Practice Manager. A lot has changed in that time, not least the number of patients being served by the Practice (from around 10,000 in 2005 to 12,200 in 2025).
With that in mind, I decided to focus on trying to properly understand the pressures on the SMC team to continue to deliver high quality patient care nowadays and Rachel's role in achieving that.

Rachel told me that at the age of 18 she had no thoughts about becoming a Practice Manager.

Perhaps it was fate then that after university and a job in the charity sector she moved to the Royal College of General Practice in London working on NHS quality programmes with Dr Theo Schofield, then senior partner at SMC. He subsequently invited her to apply for the newly vacant Practice Manager role in Shipston - Rachel said that she had always had the ethos of wanting to help people so the rest is history as they say.

Back in 2005 Practice Management was very much in its infancy, so it was a steep learning curve. Although an incredibly difficult time, Rachel pointed out that in those days there were more resources made available to GP Practices to deliver care for their patient population. The amount the Practice receives in basic NHS funding per patient in 2025 is just £123.34 per year.

Nowadays the role of a Practice Manager covers so many areas of responsibility there just isn't space here to properly cover all of them - examples being patient services, staff management, business planning, budgeting, payroll, IT systems, appointment systems, contracts and regulations, premises, to name but a few…

Despite all of these responsibilities and the need to ensure that the Practice can generate enough income to cover its operational costs, Rachel emphasised that the primary motivation for everyone working at SMC is to provide the best possible patient care.

Key to this is recruiting and retaining high quality staff (a team of around 60 is needed to provide the SMC service) and again Rachel was keen to point out that this is a very important part of her responsibility. High quality clinicians, well trained administrative staff, systems that support all staff, whatever their role, to be efficient and effective in their work. As Rachel said ‘my view always is that if you look after your staff, they will look after our patients'.

Rachel also mentioned the importance of continuous learning, with staff encouraged to report when, despite best efforts, something goes wrong. Or, sometimes, there is a patient complaint. She said it is important to ensure that any such situations are investigated, understanding the events that led to them and then where necessary modifying Practice processes to avoid a repeat. Rachel referred to some significant challenges in recent years including COVID, a growing local population, and cramped premises. On that point there is at last some light at the end of the tunnel with SMC due to operate from both the existing premises and from the Ellen Badger site by the end of the year. Again, Rachel is responsible, with the GP Partners, for ensuring that the move to a split site operation happens smoothly, with no interruption to provision of safe patient care.

With so much information to draw on this could have been a very long article so instead I simply asked Rachel to describe for me the frustrations of being a Practice Manager – and then, what she enjoys about the role.

Inevitably, there are quite a lot of frustrations – reactive NHS policy changes, relentlessly high workload with competing priorities, striving to meet the needs of individual patients whilst ensuring there is equity of access to care for the whole SMC patient population, recognising the value of continuity of care but with insufficient resources to adequately provide this…not to mention IT and phone systems and
suchlike over which the Practice has no decision making authority!

At the end of the day though, Rachel made it clear that she gets enormous satisfaction from her job. She told me she likes solving problems, likes making sure that the Practice is doing the right thing and that systems are working effectively, likes still working in an environment where she can help people. Above all Rachel said ‘my team make me proud'.

As a patient myself, but also representing other patients, all I can do is marvel at the energy, knowledge and experience Rachel brings to her job. We are all very grateful for what clinicians do for us when worried and unwell but writing this article really highlighted for me that behind the scenes, Rachel's effort means that the whole team are supported to provide an excellent service for us as patients.