Looking After Your Team Case Study: GP Senior Partner

Role and Context

The GP Senior Partner works in a medium sized practice in South East of England. The practice comprises sub teams including GP Partners, salaried GPs, physician associates, nurse and reception and administrative staff. The team was described as cohesive, but when decisions were needed the participant said, ‘All roads do seem to lead to me and the other partners at the end of the day, and it can feel that there a lot of people to supervise.”

The GP Senior Partner admitted that they were still relatively early in their GP career and became a Senior Partner earlier than expected because of a previous Senior Partner retiring at the beginning of the Covid-19 pandemic. The participant felt quite challenged stepping up into the role, as typically early on in and GP career there should be a focus on ‘cushioning new GPs and allowing them to develop into the role.’ They described the change in role as a ‘big step-up’ especially at a time when GP practices were going through a lot of change resulting from Covid-19.

Challenge of Covid-19 on the team

The GP Senior Partner explained how the practice had been through a challenging time. Patient demands were increasing, and patients were becoming more critical of the services being provided, which was having a negative impact on the reception team specifically as they were often the first port of call.

“Patients have been complaining, the reception team has had a torrid time…and that drags everyone down a bit, and there is a domino effect.”

There had also been staff absence throughout the practice, be that through staff having to self-isolate or because of practice turnover. This often meant there was uncertainty over who would manage the extra workload, staff were working over their working hours, and morale among the team reduced as ‘there was not much left in the reserve tank.’  This meant that staff teams were not working as cohesively as they could.

“We had all the cogs, but they weren’t working in synchrony and there was not a very good understanding about what was needed to get the whole machine to work.  With staff leaving and a lot of change this put us on the back foot.”

Practically, there were also operational changes in the surgery which had to be managed. Patient care was transferred to phone calls, yet there was not the technology in place to sustain the rise in calls. A non-Covid and Covid-zone had to be set-up, and communications and regulations around ‘safe practice’ were changing weekly, and updates had to be addressed. The participant felt the negativity within the practice and wanted to address it.

“I heard about Looking After Your Team and signed up because I wanted to know if there was anything that could be done to claw us back into a positive frame of mind.”

How accessing the Looking After Your Team coaching helped

The GP Senior Partner hoped that attending the coaching would help reassure them that ‘I was doing OK, and that I was not failing at everything.’  Talking to someone external to the situation provided an opportunity for reflection and the ability to discuss issues objectively. They reported that the coach was able to share leadership and management techniques relevant to decision making in the practice and when managing teams.

The coach offered an ‘urgent vs important’ model for decision making, as the participant had mentioned continually ‘fire-fighting.’  The coach suggested to focus on what was important, because if these problems were not addressed then this will cause further complications in the future. Another technique was to view the culture of the practice as a whole. For example, looking at ‘stories and how people may represent the practice and what this would mean for its reputation, and looking at ‘symbols’ and what various issues in the practice may represent.

“It was really talking all these issues through, getting help in understanding why things are going wrong, listening to the theory, and then putting tips into practice.”

The GP Senior Partner spoke about team management and how they learnt about the ‘psychological nutrients’ that employees need (autonomy, clarity, belonging, achievement, meaning and purpose). The coach helped the participant to understand the importance of how to fully interact with the practice team, to recognise what staff value in their role and to be able to be more proactive when consulting with staff.

“I recognised that I didn’t think about what people need and just moved on. It made me think about how I interact with the team and how I need to make more of an effort and give people the endorphins they need.”

Team impact of the coaching

The GP Senior Partner commented that good progress had been made since the coaching with a change in team behaviours for the positive, which were leading to knock-on improvements in patient service delivery. The coaching has started them on the ‘right path’ to where they are aspiring to be, and they now have the tools, the theory, and an understanding of the practices that they need to implement to work more productively as a team, and importantly there was a greater willingness to get there.

“People in the team have been a lot less defensive and take things less personally. Staff are looking for change, looking to make a more collective culture as we know this is good for patients.”

However, there was still a need forthe senior team to work more collaboratively, and to develop a culture of understanding and tolerance.

“There is recognition that we need to improve the system rather than blame people…there are system issues and not people issues…”