It’s vitally important within GP practices that practice staff work well together. Given the pressures of the job, all of those HR buzzwords such as collaboration, teamwork, support and harmony are of paramount importance.

One way to drive enhanced teamwork and hopefully deliver a more harmonious workforce is to set up a buddy system. Defined as a procedure in which two people, the “buddies“, operate together as a single unit so that they are able to monitor and help each other, practices seem to be embracing the idea in greater numbers than ever before.

A recent thread on the Practice Index forum covered the topic, with one practice manager commenting: “We have a system where if one person is booking annual leave they have a designated person who should cover. I did have complaints that some receptionists were doing more cover than others but after going through the holiday rota it was as fair as it could be and I had to remind them that not everyone takes a whole week off at a time. If someone keeps taking off odd days, then that will require the cover person doing more unfortunately. But on the whole, it works very well.”

Another comment, this time from Robert Campbell, added: “Certainly, the idea of cover arrangements and a buddy system I saw as part of team building. Staff were encouraged to arrange holidays and cover amongst themselves and only unresolved problems were presented to the team supervisor or the PM.

“I looked at buddying slightly differently as occasionally I saw a need to support either an existing member of staff with problems or a new member of staff to avoid problems as a way of supporting staff. One reason was that I had noticed that new and young staff were not always received well. I would say it was the J word. I appointed a buddy to act as a contact point, shoulder to cry on and source of advice. I thought it worked well.”

Wider benefits

Additional benefits of buddy systems include helping to make new recruits feel at home and aware of policies and procedures – which was why the idea was originally created – and to drive staff development. Some practices encourage staff to study or participate in training in pairs in order to make life easier and help staff feel like they can share the process. Elsewhere, practices are utilising buddy schemes to help members of staff when they are struggling to get work done.

“We’ve extended our buddy scheme by introducing a system that covers any unfinished work,” one PM told us. “Each week we allocate a different member of our team to be the ‘troubleshooter’. We really need to think of a better name! That person, agreed on a rota so that everybody takes their turn, is paid to work an extra three hours over the week to pick up on any unfinished jobs, additional tasks or work that has slipped. Staff let me know by lunchtime each day where they need help and I allocate the troubleshooter where they’re needed the most.

“We introduced it in April and it has transformed our work. Because people take it in turns there’s no worry about people taking advantage and every member of the team (7 in total) has welcomed the extra pay. The thing is, while I haven’t finalised figures, the programme looks set to very nearly pay for itself because the extra time has been used to drive child imms, promote our additional services and boost flu vaccinations etc. Staff are also happier knowing support is there.”

Setting up a buddy system

Setting up a buddy system should be straightforward enough. One PM suggested to us that in many ways it’s best to let staff set it up themselves so they have no cause for complaint further down the line.

In order to ensure you get it right, however, we asked an HR expert for advice – and these are what they advised practice managers to do:

Define the basic rules of your buddy program:

The first step to implementing a buddy program is defining its basic framework. Write down the purpose of it, goals for both the company and employees, the length of time it will operate, the ground rules for buddy relationships, etc.

In this first step, you want to showcase the broad strokes – or guiding principles – of your buddy system. This is important because these principles will serve as a basis for every decision made within the program. It will also help when defining the tasks of each buddy, which vary based on goals.

Determine the specific tasks and expectations for buddies:

Now that your buddy scheme is broadly defined, you can begin working on the specific tasks and expectations of your buddies. Start by making a checklist of clearly defined expectations and responsibilities. Ask yourself questions like: How available should employees be to their assigned buddy? What kind of help are they expected to provide? In what scenarios should they refer the new employee to PMs or other company resources?

Defining these expectations as concisely as possible will also help you select and pair up the right matches for the programme.

Easing the workload – a case study

While buddy systems clearly have benefits from an HR perspective, practices are also using them to save time and ensure service coverage. For example, some practices have a buddy system to cover early closing days, while others share enhanced services.

One initiative trialled through NHS England’s 10 High Impact Actions scheme was ‘clinical buddies’. This idea, employed by AT Medics practices in London, saw GPs doing phone consultations work alongside a specially trained member of the clerical team, who releases the GPs time by performing administrative tasks before and after the consultation, as well as connecting the patient to preventive and support services.

GPs from across this group of 24 practices take turns to do phone consultation sessions in the frontline team. These sessions are housed in a number of hubs within practice premises, with dual screen computers, headsets and access to a multidisciplinary rapid response team. Each GP sits alongside a “buddy” – a specially trained member of the clerical team, who acts as an assistant to the GP.

The buddies are the first point of contact in a telephone consultation and prepare for the full clinical consultation by obtaining details of the patients need, ensuring both the patient and the GP are better prepared to have a productive consultation. They undertake opportunistic screening and signposting, for example reminding patients about upcoming immunisations and due investigations or informing them about services in the community relevant to their situation.

After the consultation with the GP, they perform administrative tasks such as arranging investigations and follow-up, or ensuring the patient is fully aware of the next steps for their plan.

Working this way has enabled practices to improve their responsiveness to same day demand. Face-to-face consultations with GPs are reserved for those problems which need a physical examination, more in-depth input for personal continuity of care.

The use of multidisciplinary pairs of staff in the frontline teams increases uptake of preventive care, allows the GP to focus on the things only they can do, and is making it easier to connect patients with sources of care and support in the community.

A standard programme of training is used to enable clerical staff to work as buddies. This is accompanied by system of continuous audit and improvement, through the use of team debrief after each session, a shared issues and lessons board and continual learning shared between each GP and their buddy.

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