Empowering GP practices across Ireland

Ms Rachel Bothwell, Irish Early Career Awards Entrepreneur of the Year, speaks to Niamh Cahill about how she established a thriving professional development network for GPs and practice managers

Wicklow native Ms Rachel Bothwell was just six weeks into an overseas trip in Tanzania, teaching business to women in a small school, when her father was diagnosed with pancreatic cancer in 2018.

She came back to Ireland and began helping out with the family business, Arklow Medical Practice. Her father, Dr Ian Bothwell, has thankfully since made a full recovery.

As she explained to the Medical Independent, Ms Bothwell had intended to spend two years in Australia. She was jobless on her return and more than willing to lend a hand.

“I didn’t have a job so I was able to go into the practice as both mum and dad had stepped away,” she recalled.

Many summers and spare time had been spent over the years working at the two-doctor teaching practice, but this occasion was different.

Having previously worked in fashion buying and marketing, Ms Bothwell always had a keen interest in business, but never imagined a career in healthcare.

“I grew up in a GP practice family. My dad’s a GP and my mum was a practice manager.

“But I gave up science at Junior Cert. If you told me then I’d be working in healthcare now I’d have laughed at you,” she said.

The enormity of the workload in practice management soon became apparent.

“As I got stuck in I didn’t realise the scope of it, the complexity of it. And the more I dug into it I realised there was a lot to it.”

Not one to shy away from a challenge, however, Ms Bothwell undertook an ICGP practice management course in 2019 and 2020, even though she was still not planning to stay in the practice long-term.

“But I could see early on there was scope for a consulting business or something on a larger scale. I really felt there was no support there for practice managers at all.”

“It became really obvious when I did the ICGP course because I met more practice managers and realised how isolated people feel. That’s where the idea grew out of – to initially put resources online and give people a forum and a place to talk to each other.”

GP Practice Ally

In early 2021, GP Practice Ally (GPPA) was launched. Ms Bothwell built the entire website, gppracticeally.ie, herself.

It is the first service of its kind in Ireland to provide support services and a communications network for GPs and practice managers.

Now members have a network through which to contact other practice managers.

GP Practice Ally’s membership is an equal mix of GPs and practice managers. The business currently has over 1,800 members spanning around 75 per cent of practices nationwide.

A range of services are offered, such as service directories, training, updates, and a forum through which members can converse, share ideas, and seek support. Helpful guides on many of the State contracts, through which GPs provide patient care, are also provided.

Membership is free, but a premium paid membership service was added in 2022 providing further resources in areas including finance, human resources, operations, and chronic disease management.

Webinars are offered to members and have included topics, such as health and safety, practice finances, and updates to the GMS contract.

Training

All the supports help to empower practice managers and enhance dialogue on practice management, Ms Bothwell explained.

“It set out to be a practice managers’ community, but it’s now very much a practice management community because you see GPs also want access to information and they want to be able to ask questions or bounce ideas off practice managers,” she said.

GP Practice Ally offers a 10-day practice management programme to members over five months, which amounts to two days a month.

“The focus is on how to introduce a culture of continuous improvement and to implement change. That’s the overarching focus.”

Next year Ms Bothwell hopes to expand the training programmes in response to a huge demand for medical receptionist and administrator training.

“We are constantly asked for it. It is such a difficult role. People are getting abused on reception desks. It’s a massive problem and people are really struggling to retain staff because of it,” she said.

“If you could direct a lot of traffic off the phone and onto your website…. Can you imagine if you rang a GP practice and you’re on hold for 20 minutes and you’re already in a fairly anxious state, you’re not well. You’re escalated to a level when you do reach someone on the phone and reception staff are stressed.

“A lot of it is about giving people conflict management skills or communication skills. What we look at in the practice management programme is how can we deliver a better patient service – that’s overlooked in healthcare. It is a business and our patients have needs and wants.”

This is where practice websites can help, which is another service provided by GP Practice Ally.

“If somebody wants to cancel a GP appointment at 11 o’clock at night they should be able to do that because often they’re not going to get through at 9am on the phone,” according to Ms Bothwell.

Ms Bothwell has delivered more than 70 GP practice websites to date while a further 30 are currently in development.

After the initial website construction is complete, an annual licence fee is paid to GP Practice Ally to maintain and update the site.

“For example, when the age of entitlement to free contraception changed that update was made by us to ensure information on the sites is up-to-date.”

An annual summit was launched by Ms Bothwell in 2023. The theme of this year’s two-day summit was “culture of collaboration”.

“At the summit we would have had lots of single-handed GPs that don’t have a full-time practice manager or were looking to maybe expand that role or were looking for more information before going about that,” Ms Bothwell noted.

The GPPA Planner has been another success story for the business. The 365-day planner contains lists of annual and monthly tasks, a daily planner, and wellbeing checks.

Its aim is to “enhance the planning and organisational skills of practice managers”, Ms Bothwell explained.

Goal

Ms Bothwell’s overall business goal is to help ease the pressure placed on practices whose workload burden has increased. 

“I’m not going to be the one to solve the GP capacity crisis, but the role we can play is development of the practice manager role and by streamlining things. The idea would be to make things much more efficient so that there is less work to be done in certain areas that could free up administrative time… it’s about giving practice managers confidence. That’s a huge thing. It’s not rocket science.”

In a recent survey conducted by GP Practice Ally, 70 per cent of practice managers had previous general practice experience before entering their current role.

“This means it is quite likely they never had any formal business training if they were promoted from a receptionist role. That’s quite often what happens,” according to Ms Bothwell.

“The role has become so complex now people are afraid to do the wrong thing. There is so much to keep on top of, it is really overwhelming, and you’re just doing the day to day firefighting. So what we try to do is just break things down… we really focus on getting standard operating procedures in place where there is consistency across the business. It is about treating it like a business.”

Award

In September this year, Ms Bothwell’s achievements in business were recognised when she won the Irish Early Career Awards Entrepreneur of the Year. It was an accolade that left her both shocked and delighted.

“The judge said that I was recognised for impressive results, but mainly the actual creation of the community and embodying the values of community, kindness, confidence, and curiosity… and my resilience having built the business from what happened with dad.”