Success in challenging times

“GP practices across the country are experiencing significant and growing strain with declining GP numbers, rising demand, struggles to recruit and retrain staff and knock-on effects for patients.”

British Medical Association?

?After a couple of tough years for the NHS, practices are feeling the strain;?teams are under immense pressure to meet demand.??????

According to NHS Digital, there were 5.4 million more appointments booked in March 2022 than in March 2020 and demand shows no signs of slowing down.??

It’s not surprising that more and more practices are reaching out and asking for support…?

A practice serving almost 9,000 patients (and growing) was drowning and they turned to the CCG for help.??

Theirs was an increasingly common tale of woe, with challenges presenting themselves on multiple fronts:?

Team:?

• The lead partner was embroiled in complicated and drawn-out talks to renew the practice lease. He was also due to take his 24-hour retirement and start to reduce his hours. He was unable to do that, however, until a replacement was recruited to make up his time.?
• The good news was a GP had been recruited, the bad news was, the change in partnership was subject to the renewal of the practice lease.??
• This ‘catch 22’ was impacting the amount of time the lead had to spend with patients, placing more demand on his already overstretched team.?

Recruitment:??

• After an unfruitful recruitment campaign, the practice was reliant on using agency staff on reception; a costly and time-consuming alternative to recruiting permanent staff.??
• There had been no Practice Manager for months and the team were reliant on a PM from a neighbouring practice supporting them 1 day a week.??

Administrative:?

• ?The practice had recently recruited a Business Manager, however, she had no experience of NHS systems and required support and training in order to fulfil her role.??
• There was a backlog of activity across the practice. Patient registration, scanning, the provision of online access and general email communications, were just a handful of the areas which had fallen behind.???

Faced with a difficult situation, the practice requested support from the CCG who took the decision to bring in outside assistance; enter Libera Partners LLP.?

Our Initial Observations:???

Upon entering the practice for the first time it was evident that the team were in need of direction; a full-time practice manager was required and fast.??

?Everybody appeared to be firefighting; there was confusion over roles and responsibilities, and lack of clarity when it came to carrying out tasks.??

?Our Approach to the case:?

At Libera, we believe that having a clear strategy is key to the smooth execution of any service.??

When it came to this particular practice, front office, back office and clinical operations all needed our attention.??

We quickly pulled the teams into a meeting?where we discussed?issues and gained their trust and input into how they felt things needed to change. ?

It was important we spent time working on site with the people most affected by the inefficiencies of the current systems.?

By involving the existing team at a grassroots level, our aim was to keep them engaged through the transitional period and beyond. It’s our belief that people are at the very heart of every workplace and therefore need to be consulted and involved in any organisational change.??

Interestingly, according to a recent staff survey by NHS Digital, less than half of the NHS workforce feel like they are consulted when changes are made.??

Once we’d gathered this feedback and observed the team at work, we soon had a clearer view of the case at hand and devised a structured plan of improvement for the practice.????

What we did:?

• It was clear from the outset that the practice recruitment strategy needed an overhaul.?We advised the team of a different approach to recruiting and even tapped into our own networks to source potential candidates. As a result, new team members were recruited and trained – ready to hit the ground running and clear some of the administrative backlogs.?
• This recruitment upgrade also resulted in the practice successfully recruiting a new Practice Manager. We supported her in her transitioning to the new role, engaging with her in shaping?plans and actions, so she was firmly positioned as the PM with the team she was joining.???
• When it came to team roles, there was some overlap and confusion about individual responsibilities. We worked with the teams to define their roles, providing clarity and some focused training where needed.??
• We advised the senior members of the practice on ways to deal with the underperformance of team members. This resulted in several people leaving the organisation, however with the new recruitment strategy in place, their positions were quickly filled by better-suited individuals.?
• The lead partner was eventually able to agree the lease terms, and we were happy to support the practice in bringing a new GP partner onboard.??
• With many new faces and changes to strategy, it was important the team did a little bonding. Working with senior staff, we devised an ‘away’ day for the team to allow them time to get to know each other a little better. The interactive session included games, a review of practice strategy, team development and training in specific protocols.

?It was also a time for the leaders to motivate the team and engage them in achieving a common goal. Although the presentation was developed by us, it was led and delivered by the local team.??

As we strategised, we provided a sounding board for the practice executive team, checking in with them regularly to assess the progress and gain feedback.??

How did we do??

As with most situations like this, the CCG funding was limited; allowing us a short amount of time to put a dent in the backlog of work. Once the CCG funding ran out, however, the practice, so impressed with the headway we’d made, requested we continue to support them in completing the rest of the work.??

?Such fantastic result and testament to the great work that we do!??

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Future-proofing?

When using the services of a Management Consultant, there is often the concern as to whether the new strategies will continue to work to the same standard, once the contract has ended.???

At Libera, we use a consulting/coaching approach; we not only advise on and implement new strategies, we empower the client to confidently continue the good work.??

?Since our contract came to an end at the central London practice, the surgery has continued to go from strength to strength.???

• The team have made great progress with the huge administrative backlog they were suffering. The ‘new ways of working’ we helped to implement will now ensure the practice never falls behind like that again.?
• The new recruitment system is being used and the practice has successfully brought on several new team members.?
• As part of training the new PM, we identified issues around income. The PM has successfully dealt with this problem using our new process to track finances.??
• The away day was quite a success. They enjoyed it so much in fact, the practice has plans to hold more in the future.??

Don’t just take our word for it; here are some testimonials from the team themselves:??

?“I’d just like to express my appreciation for all of your help over the past year! As you know, we have made more progress since – I think it’s in the right direction, fingers crossed! Your work gave us the initial push and a solid foundation to build upon. Hopefully we become one of the better practices in the future and we may be the role models for others – if that’s not too high an ambition.”?

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“I’d like to thank you for our training day, yesterday. I am really pleased that we pushed ahead despite the timeline and held the day. It was really enjoyable and I think it was a great start in bringing the practice together. I hope we can hold more events like this in the future as the team grows and develops.”?

As you can see from the feedback, our time spent with this practice was an all-around success. Not only are the team efficiently working through the backlog, but they’ve also gained a sense of unity that was lacking after months of firefighting and stress. They now have a strong Practice Manager in place, who together with the senior partners, can confidently steer the practice through any challenges that lay ahead.??????

Does this story resonate with you??

?If you’re responsible for a practice with similar challenges, why not contact us to discuss how we can support you???

About Libera

?Libera Partners are a Management Consultancy providing strategic advice to health organisations and supporting them whilst they make changes to their services.??

We have experience working with general practice across the UK, from organisations in crisis, to those who are embarking on major change.??

We know first-hand the pressure placed on practices to perform; we have a firm understanding of NHS data, targets, and systems. This knowledge, combined with our passion for engaging both teams and patients in what we do, made us the ideal consultants to work with the practice to address their challenges.

Email: [email protected] ?

Phone: 07803736911?

Get in touch today and be part of the solution.??