A wise observer once said that teamwork is the ability to work as a group toward a common vision, even if that vision isn’t always clear.
This statement is never more relevant as rising patient demand pushes NHS surgeries to their limits; we need everyone fit and firing to provide the best possible care - but we also need everyone understanding the goal we are working towards and the different roles that individual team members must play in reaching it.
Last year, our practice had to quickly reorganise its administration set-up after a previous partner left. Though we did the right thing by appointing a new practice manager and deputy, we had inadvertently created an environment where key team roles were not 100% clear.
Our surgery embodies the truism that primary care must adapt to support an ageing population; we are based in the seaside town of Bridlington and have over 6,000-patients. We serve the third highest retirement destination in the country.
While we had a practice manager primarily focused on NHS funding and reimbursement and a deputy manager mainly handling staff administration, their roles sometimes overlapped. There were misunderstandings over scheduling and front desk matters. And, along with this the atmosphere wasn’t great either.
Why we decided to get outside help
As health professionals, we’re about inspiring people to change but in the hurly-burly of a GP practice, we decided to look outside to make change happen from within.
Any busy workplace will hinder fresh thinking to a degree so we felt it was critical to take our team out of their usual environment. We asked Nick Bradley, the founder of Mandala Leaders, a leadership coaching consultancy, to refocus our team’s approach. He recommended a one-day, off-site coaching session where each participant starts from their own ‘safe place’.
We set the company three outcomes from the coaching: first, restore team trust, second, build the mutual support needed for their roles and responsibilities, and third, persuade the colleagues to draw up an outline business plan.
Both the practice manager and the deputy liked the idea of getting out from their usual workplace for a rethink - but we also wrote hand-written notes to them, recognising the commitment they were making.
What did the coaching involve
The coaching was organised to take place at a local hotel (away from work but still accessible) that focused exclusively on the two managers and their needs.
Dispensing with classroom-style teaching, the coaches quickly built that ‘safe place’ for our colleagues to consider change. The coaches started with exercises that engendered greater trust between the two managers - followed by sessions that explored the pair’s approach to each other and their methods and how they ran the practice. The duo even reconvened by the flipcharts in late afternoon to agree a new approach to surgery management – a plan for a plan.
Our practice manager said afterwards that she’d never been on a course quite like it. She found herself being gently challenged to contribute, rather than being told. She also said the coaching’s emphasis was on what they as individuals thought their role in the practice’s mission was - and how and why we came to be where we were with some misunderstandings and miscommunications.
The coaches didn’t tell our staff what to think - they guided them to their own conclusions.
Our deputy manager said the coaching asked both of them to take individual responsibility for improving the way they operated – and how the team as a whole worked. But these insights came from the managers themselves, not from external pressure.
Twelve months on, back in Bridlington, the practice team has a real appreciation of each other’s role and skills and how to drive the practice’s commercial plan. The two managers work more closely together, and are clearly more outcomes-driven. There’s a more harmonious atmosphere, for staff meetings, rota sessions and dealing with patients and suppliers.
We’re seeing a better-focused and happier workplace. Our practice played a part in our CCG being shortlisted for healthcare excellence awards for its successful partnerships with other GP groups and local authorities in delivering public health policy.
Our practice manager prioritises and thinks things through rather than ripping through all those emails and calls. Her deputy appreciates that the coaching session helped them better understand each other’s needs. The whole thing was totally different from the classroom-based, ‘top-down’ exercise that they had expected.
As partners, we are about inspiring behavioural change. For team members to grasp the need for change and act on it, they must feel comfortable with the course leader and themselves. This ‘coaching from a safe place’ has helped our team members rebuild mutual trust as well as release their potential.
- Dr Tom Milligan and Dr Dinesh Kumar are GP partners at PracticeOne in Bridlington, East Riding of Yorkshire