Your questions answered By Lyn Longridge Radcliffe 116 pages £12.50

This is an excellent book that seeks to present information and advice on the extended role of the practice manager, both for those with experience and increasing responsibility, and for others who are new to general practice. Its unambiguous guidance is based on extensive practical experience, and the question-and-answer format is an effective medium. The reader is skilfully guided through the maze of primary care roles and responsibilities. To the uninitiated, these roles can appear both complex and potentially unmanageable, but the author uses all of her knowledge gained in primary care management to explain the matrix that is essential to the delivery of good healthcare in a demand-led setting.

The skills and tools required to manage such a diverse team and the practice as a business are explored and elaborated on through different scenarios of events and circumstances.

Although strategy and business planning are described in a somewhat 'frill-free' way, anyone new to practice management could certainly produce a robust plan by following the action points. Furthermore, only someone who genuinely understands the complex financing and culture of general practice could have written the SWOT analysis with the emphasis on 'keeping options open and suspending judgement'.

The book is very much in the 'Irvine mould' in how it deals with quality management and how this impacts on patient care and services. Certainly, establishing a culture where standards are both agreed and owned is not new, nor is the sensible assertion that all of the primary healthcare team will need to work within an agreed timetable and framework. But getting GPs to agree with each other and to work within a common framework is akin to herding cats, and perhaps the role of management in the process could have been tackled under either the umbrella of 'quality and standards' or 'the management of change'. Certainly, primary care group chairs will have to take these issues on board if they are going to have any success, and the author's views and suggestions on how this could be facilitated would have enriched the reading.

Nevertheless this book excels as a handy reference tool and valuable source of information based on extensive practical experience, not least in recognising the most unusual business that is general practice and the situation that is practice management.

In this post-white paper period, the scenario on motivating staff could easily be taken on board by many GPs. The latest reforms have certainly contributed towards low morale and uncertainty, and perhaps for the first time GPs see themselves being harnessed into compulsory groups of 'un-like' individuals with whom they have little in common, with the danger that they become thoroughly demotivated and switched off.

Perhaps the role of the practice manager of the future will be to stimulate or stifle self-motivation, depending on who signs the salary cheque.