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What to do when you're struggling in your PCN management role

The role of the Primary Care Network leader requires us to continuously bend and flex to suit different working cultures and communication styles.

Some practices like to be involved in every element of the network, dictating emails and tightly managing conversations.

One person says; "yes" to your face, and then "no" behind your back.

Others are quite happy to let you get on with things.

You are in the middle, trying to make everyone happy and either feeling like you are struggling at best or outright failing.

In this blog, I share three key pieces of advice to help you navigate your way through this, and invite you to:

🎯 Review, Reflect and then Act

🎯 Start Afresh

🎯 Ask Questions

It's so simple right...?! Simple, yes, but not alway easy to do.

Let's jump in!

I would be lying if I didn’t say that sometimes, we have struggled with engagement and juggling different expectations. And we still do, despite our significant experience in supporting over 120 PCNs in a variety of ways. Every network is different due to:

🌀 Multiple personalities

🌀 Different communication styles

🌀 Varying levels of motivation which, in turn, impacts our ability to engage

🌀 Practice and PCN politics

🌀 Levels of trust amongst colleagues

🌀 Different levels of expectations

🌀 Variation in how people prefer to consume information

🌀 Different levels of risk tolerance

🌀 How people view different professional roles

You get the picture.

It’s a challenge, but once I get to know all of their different communication styles, their motivations for the PCN, difficulties they have had in the past, how they like information presented to them and what they truly want, this is where we start to see positive results.

Having discussed this recently with some peers who are not strangers to this situation, together, we recommend the following:

1. Review, Reflect and then Act

It’s usually obvious when things aren’t working well, communication feels strained, and expectations feel unclear, or out of reach. In this situation, quickly call a meeting, raise the issues and be prepared to act on the feedback.

Try to be objective and do not let your emotions get in the way if you feel the feedback is not a fair reflection of the situation. Always remember; you have the skills, experience and the resilience to bounce back.

Dr Ursula Montgomery, GP and former NHS England Senior Clinical Advisor and latterly, Interim NHSE Director of Primary Care, gave me a brilliant piece of advice to help me in these situations, which is; there are multiple truths to a situation, we will all see things a bit differently...and this is okay.

In preparation for (and after) your meeting; review the situation, reflect on your role, consider your communication style, what you need to deliver the project, the brief and context, and then act on any improvements which can be made.

Lastly, if you have made mistakes, admit them.

For more leadership lessons, check out the podcast I recorded with Ursula here.

2. Start Afresh

Now the most difficult part is out of the way (acknowledging and addressing the issues), start afresh and move forward. You have work to do, and people are counting on you.

In most cases, it’s a simple misunderstanding or clash of personalities, but you are a professional and you are good at your job. Start afresh, be positive and continue.

Don't hold a grudge, don't be petty, and don't be passive-aggressive.

Show up, even if every part of you wants to run and hide. YOU ARE A LEADER, and this is what leaders do. They show up even when they really don't want to.

Get the awkwardness out of the way and show them you mean business! 👊🏾😀

It's also worth noting that your fresh start may also mean moving on. This is ok. You have not failed. This situation has simply revealed that there is a mismatch in what you both want and need, which in the long run, is good for everyone.

3. Ask Questions

A lot of misunderstandings occur when we are frightened to ask questions, but it’s your job to clarify the next steps in a project. You are not a mind reader.

Asking questions is the simplest, most effective, and most essential aspect required to facilitate progress.

Be direct so that you understand clearly what is expected of you, what the task is, and what approach is required.

Check out our blog titled; 'Key questions to gain more clarity in your PCN Manager role' to help you formulate your questions, but I would always start with

❓ What

❓ Who

❓ When

❓ Where

❓ Why

❓ How

❓ How much

Lastly, when it’s taking you a little longer to get into your groove, remember to;

😀 Just be you

😀 Relax

😀 Adopt a positive and can-do attitude and NOT a victim mentality

😀 Seek support from your boss, a peer, a coach or a mentor

😀 Trust your gut

😀 Dig out past training materials on communication to remind you of important concepts and frameworks

😀 Remember - one size does not fit all, and you will have to adapt to the personalities within the network

😀 Stay true to your values

Further Resources

If you are getting ready to deliver some bad news or difficult feedback, check out this blog and podcast. I have been there my friend, but you will get through it, and you will feel so much better once you have the conversation.

You may also want to check out our blog; 'What are you tolerating in your primary care network?'. I originally wrote this in September 2020, then updated it again in December 2022, and it's still relevant today.

Good luck, and I hope this helps!


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About the Author

I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 250 episodes.

I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 120 PCNs by providing interim management, training and consultancy.

I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs.

I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.


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