Looking After You Too Case Study: Salaried GP

Role and Context

The Salaried GP works in a practice in North Yorkshire for 3 days a week.  They have been a GP for over ten years but have worked in their current practice for 3 years.  The practice covers about 15,000 patients and is based over two sites, covering both affluent and deprived communities.   At the time of the conversation, the Salaried GP had been signed off work with work-related stress.  They described how the impact of the pandemic, home-schooling and the Covid-19 vaccination programme had ‘basically all got a bit too much, and I was beginning to find things rather challenging”. The Salaried GP is also a GP appraiser, as they believe it is important for GPs to receive development opportunities as this will help with GP retention.

Challenge of Covid-19 on own wellbeing

The Covid-19 pandemic and the resultant changes to GP service provision resulted in a number of changes to the Salaried GP’s wellbeing.  They were attempting to home-school their children with little support, as well as continuing patient treatment (now on a phone triage system even though they still worked in the surgery), and the practice was experiencing difficulties with staff retention.  The GP Partners also expected them start on-call work, as other salaried GPs were seen as more clinically vulnerable.

“The Salaried GPs were expected to go into the surgery, so we did more face-to-face work if patients had to come in.  I felt a bit put on because I was having to go in all the time, and then they also asked me to do on-calls.”

Team morale at the practice was described as ‘very low’. Having to socially distance in the surgery made work isolating, ‘you are in a room all on your own and that makes everything more challenging’, and practice socials had been discontinued.  A social media group was developed to keep staff connected, however the Salaried GP felt like they were struggling with their role and was finding it increasingly more difficult to talk to the GP Partners about their work and workload.

“I just found that I was becoming a wet lettuce, and they kept just putting more and more work on my list.”

How Looking After You Too coaching helped

Having broken down at work and telling their GP managers that they were not coping, the Salaried GP noticed that something needed to be done to help them.

“My mood was getting lower, and lower and lower, and I thought I had been managing. And then all of a sudden I wasn’t.” 

The coach was able to quickly realise that the Salaried GP was experiencing burnout, but at that present moment was ‘in the thick of it’ and the coaching sessions enabled them to take several steps back and reflect on the situation and make decisions about how to take things forward.  The coach questions the Salaried GP about what would really satisfy them at work, and they felt this was something they had never thought about previously. Through the sessions they were able to identify aspects of the GP role they enjoyed, why this currently wasn’t working and how they could rectify this in the future.

“The coaching helped me realise I still wanted to work, but I just had to work out what was right for me.  The coach re-iterated that it wasn’t me being bad at my job, but I was burnt out, and I needed more input into what I am doing.”

The coach also provided the Salaried GP with a development matrix to encourage them to think about where they would like further training and provided techniques (focussing on transactional analysis) regarding how to have structured conversations with the GP Partners to ensure that their voice is heard in future discussions.

Impact of the coaching

At the time of the conversation, the Salaried GP had partaken in 3 coaching sessions, and was waiting for their return to work to book their last.  They viewed the coaching as a positive experience, as it provided the time and space to discover what they needed to do work-wise to help their wellbeing.

They will not hesitate to have further coaching again in the future as they really enjoy their job, and felt that additional coaching could provide the necessary skills to maintain their wellbeing in the future if further challenges arise.  The coaching has given them the opportunity to understand what they wanted to achieve from their role, for their good and the good of the practice.

“The coaching made me realise I wasn’t worthless.  The coach gave me lots of hope and that was pivotal to my mindset…It has been a really positive experience. The coach was a cheerleader.”