Less of the C-word, in Primary Care please!

I remember hearing a comedian talk about how the F-word in the British language is used as a noun, an adjective, an insult, a verb, a compliment and more.

I've come to realise that in Primary Care, the word 'capacity' has come to have similar functionality. Here's a few...

A target: Capacity is often framed, usually from above, as a target for services.

A pain point: A regular issue in practice partnership and management meetings, where staffing resource is felt as a pain point that cannot be ignored, pushing everyone to give a little more on top of the more they already give.

A culture barrier: 'No time' to meet as a team, no time to work on the culture...

An innovation barrier: No capacity to innovate any faster or in more directions and/or fear that the innovation will reduce capacity if successful (e.g. online consultation).

A retention threat: Staff burnout feeling directly related to capacity versus demand issues.

Capacity is so steeped in the negative connotations of its feebleness in relation to the looming beast of demand, that I'd argue it might have outgrown its purpose and may be more of a swear word now than a helpful word.

Losing its value?

Service development has hung on the golden equation that capacity vs demand underpins service design, job plans and staffing allocation. But in a world where the leaders are influenced by a wider NHS culture, expected to push on, to work more, to sacrifice more... this equation nearly always results in capacity going up as a result of hours at work going up.

In this long established model of capacity management (or fire fighting as it is more commonly known), we are seeing sustainability at threat with 1/3 of GPs and Practice Managers openly discussing their desire to leave primary care in the next 1-3 years.

It's time for a new C-word for partners and managers to get their mouths around.

The New C-Word: Culture

Outside of Primary Care, the public sector really... culture change is raging as the dominant model to support the need to innovate fast, retain great staff and avoid burnout.

Organisations are realising that the world is changing at lightening speed and systems can't rely on pressure from the top to adapt their own systems at the pace needed to survive.

Culture by design is proving itself to be key to resilience, retention and innovation. Where teams are littered with a new language of C words that direct them towards success... connection, capability, cohesion, creativity, captivation... all wrapped up in a culture that feels like the team are on a mission to solve the opportunity of 'demand' as a united collective. Experimental innovation is the core culture and celebrations of efforts to learn are flowing like an open tap from the leaders at the top.

GP Partners - where to start?

In our work with partnerships and PCNs, we always start with the partners. Shifting their perspective from medics in business, to businessmen who are medics. Understanding that the culture of their business drives engagement, profit, personal fulfilment, sustainability and a sense of joined up teaming.

We build the confidence to trust themselves, to activate their team to be creative. As creative and engaged teams truly do solve capacity issues. It is a really hard risk to take for medics, where slowing down - and being strategic leaders is the primary task of leadership, rather than heroic efforts that are short term effective and long term unsustainable.

This article is simply a call to action for Primary Care leaders to prioritise culture.

I've made it easy - provided you with a FREE book on how to get started.. here's its review from the Director of the Practice Manager Association...

The secret to success when under pressure is a culture of teamwork and this book provides a very usable blueprint. All skilfully explained, well-reasoned – and importantly, easy to apply. Dr Craig Newman demonstrates a clear and thorough understating of the challenges in delivering primary care services as part of a multi-disciplinary team. If you’re looking for positive insights and approaches to success in primary care – you’ve just found them

Beyond this, I'm of course happy to discuss how we can help your team directly (book a call or PM me here on LinkedIn)

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