Workforce has long been a challenge in the NHS.  Before the NHS, care was chargeable and a doctor’s advice was only sought if it was urgent or you could afford the fee. The advent of the NHS means that we’re now better able to manage long term conditions and help our patients with issues that they previously wouldn’t have considered would be “fixable”.  As times have changed, so too have our practices.  Where once a single-handed GP working surgeries and covering out of hours was the norm, we’ve moved to larger patient lists becoming the standard.

With the recruitment and retention of GPs an ever present challenge, what can we do to help our practices to prepare for the challenges ahead?

The NHS Long Term Workforce Plan (England) gives a flavour of what general practice of the future might look like.  Changes in recent years look to working at scale, with ICBs replacing CCGs, and PCNs becoming further integrated into the world of primary care.

So, what does this mean for us at a practice level?  The advent of ARRS roles in PCNs has meant that as practices we have access to a wider range of roles to support our patients than ever before. Where once the GP was expected to be the first point of contact for everything, we can now make use of roles that are geared to the broad challenges of the modern practice.

With the financial stresses placed on practices by the most recent five year funding deal, we’re not always in a position to compete with secondary care providers on a purely financial footing.  So what can we do to ensure that we provide an attractive place to work for our staff?

It’s often said that you’ll never get a second chance to make a first impression, and never is that more true than in recruitment. We’ve all had candidates who arrived for interview and left a lasting, and not altogether positive, impact.

The same is true for us as employers, we don’t get a second chance to make a first impression.  How do we present ourselves to the wider world.  Does the language that we use give a good guide to what we’re actually like to work for?  It goes beyond that simple first impression though.

When we’re looking to fill posts, have we understood how “essentials and desirables” actually look to our candidates?  Do we understand the impact that these have on who applies for the roles we’re recruiting for? Have we controlled our processes so that candidates have a seamless impression of the organisation?  Have we fully considered our routines for onboarding new staff.  Does the sum of our recruitment and onboarding say “I’m lucky to join you”?

If you’d like to ensure that your recruitment and onboarding is top-notch, we’ve got the ideal session for you. Effective Recruitment covers a broad range of topics to help you to ensure that you don’t lose potential new staff at the first hurdle.

Retention is proving equally testing.  In an environment where the press often features negative stories about general practice, the impact on staff satisfaction and retention can be significant.

What do we know about organisational culture? Is it positive and does it allow employees to speak freely and feel supported? Does our culture encourage burn-out or do we recognise and underpin the need for an appropriate work-life balance?  Do we hold ourselves to account for ensuring that our staff are empowered to make appropriate decisions?

If you’d like to better understand the links between culture and retention of staff, our informative session on Employee Retention can help you with positive steps to ensure you retain staff even when others are losing theirs.

When we’ve successfully recruited and retained staff, the next challenge for us is the process of appraisal.  While doctors and nurses are subject to additional re-validation and GPs to a process of external appraisal, the importance of the internal appraisal process can’t be overstated.  Performance management is often conflated with appraisal and while it’s almost inevitable that there are some overlaps, appraisal should broadly be a positive process.  A well managed appraisal process is an essential part of the practice management toolkit, offering an opportunity to reflect on the year that has been, and the year that is to come.  Do you talk to your staff about their ambitions and aspirations? Frank and open discussions can help to alleviate frustration and misinterpretation.  When thinking about the values and vision of the organisation, can you clearly link their themes to the objectives and appraisals of your staff? As part of the workforce and wellbeing quality improvement domain, have you considered the vital part that appraisal plays in understanding and ensuring the long term wellbeing of your staff?

Our Appraisals training can help you to establish positive cultural and staff wellbeing  benefits from a reinvigorated appraisal process.

Without a doubt, staff are the biggest single resource we have and often the greatest expense too. If you’re looking to empower and strengthen your workforce, the HR Bundle from Practice Index Training offers the essential courses for today’s primary care team.It makes sense to nurture our staff relationships, we spend a great deal of our working lives with our colleagues and a long term positive working culture is fostered by happy staff.