Looking After Your Team Case Study: Kirsty – Lead Advanced Clinical Practitioner

Role and Context

Kirsty is a lead advanced clinical practitioner and leads a large team, including paramedics, physician associates and advanced nurse practitioners. She is based in East Yorkshire and works for a GP partnership which cover four GP practices.

Kirsty has been in the role for just over two years, and duties in the role include line management for everyone in the team, undertaking appraisals and personal development reviews, setting team rota’s, developing team support structures and managing sickness absence. This team management role sits alongside her clinical duties. This was Kirsty’s first leadership position and she ‘has learnt a lot’ but did begin to see the demands of the role as a struggle.

Challenge of Covid-19 on the team

Kirsty had only been in the team management position for around four months before the Covid-19 pandemic started, as the role had only just been developed, so she was still in the process of setting out the new team structures when the pandemic began. The consequential speed with which changes had to be implemented became quite challenging. The clinical demands for her team increased dramatically, enhanced by having to learn new processes for the provision of patient care.

“Clinical demand is extremely overwhelming; we have been doing more triaging and e-consultations and that’s been a new learning process as it is not something that either myself or the team had done before.”

Initially, the team had a positive ‘we can get through this attitude’, but as the pandemic continued Kirsty noticed that her own and the team’s wellbeing had reduced, and tasks were becoming more overwhelming. Communication in the team was breaking down as social distancing meant that teams could not meet face-to-face, and she realised that her teams were struggling with different emotions at different times. Trying to manage a more dispersed team became an issue as some staff felt they had lost their previous support structures. Kirsty felt that she could be managing this more effectively.

“It was quite draining to deal with the impact of this on the team wellbeing… virtually everyone in the team had a period of time when they struggled, even those who had never had previous struggles...” 

How accessing the Looking After Your Team coaching helped

When having a conversation with HR, Kirsty mentioned that she had ‘self-recognised’ that she needed to access some kind of support to help her manage her team more effectively through this period of change, and it was HR that alerted her to the Looking After Your Team coaching service.

 “I knew that I wasn’t managing things and the team very well and could see that I was becoming increasingly overwhelmed, and I was blaming others and trying to find other reasons for how I felt. I was in a place where I just couldn’t reflect properly.”

Through the six sessions that Kirsty had with her coach, she was able to describe the situation that she was currently experiencing and was provided with a number of tools and coaching methods to help with team management. For example, Kirsty discussed how the coach identified a need for her to be more open and honest about communicating what the management changes to the team structures would entail.

Alongside this, Kirsty was coached on how to tackle difficult situations effectively and how to initiate and manage difficult conversations. This involved practical strategies such as organising meetings at times suitable for all necessary attendees, planning the structure of meetings, and sending out an agreed agenda before the meeting, so all involved knew what would be occurring. The coaching also included methods of active listening and reflection, so in team conversations Kirsty would be able to identify what the team issues are, and how she could respond in the most positive way.

“It gave me ways to understand what the next actions could be and how we could move things on. It was a way of how to structure difficult conversations to show that I have listened and reflected on the issue that they have raised, and when responding being really careful in the actions that we are going to take as a result to moving on to get to the end point.”

A further issue that was addressed through the coaching was making affective use of personal development reviews (PDRs), so that individuals in the team knew what their roles would be and how they would develop. The coach highlighted how time could be best spent to ensure that PDR meetings were planned and structured, and enough time was scheduled in to make sure that any issues raised could be satisfactorily addressed.

Team impact of the coaching

Kirsty was open with her team that she was attending the Looking After Your Team coaching service and found that her team responded positively to any changes. Kirsty mentioned how the team feel that she is more approachable and willing to discuss any changes they would like to be made, and that team members also had greater understanding of what their roles in the new structure were. 

“It has opened up new and different channels of communication, more positive ones then previously. It has brought more mutually respective conversations, and the team are more open to me, as they now see me as a person with feelings, and not just as a leader.”

She added that coaching helped to gain a team perspective on various situations, which she may not have previously considered when she felt overwhelmed or pressured to make decisions. 

“I feel like the team coaching has given me enough tools and enough knowledge that I can now go forward and tackle the team issues that I need to. I benefitted from the coaching, but I can also see that the team has too.”