However positive you try to be, however hard you try to motivate morale across the practice and however hard you work to try and keep patients happy, there’s no escaping the fact that 2020 has been extremely challenging for practice managers. COVID-19 has turned the world on its head, making an already stressful, difficult sector to work in, much tougher again. As we approach World Mental Health Day (10th October 2020), it is the perfect time to think about work/life balance and coping with pressure.

“I feel like I’m stating the obvious here, but it has been really hard to keep everybody motivated across the practice,” one practice manager told us. “We were already stretched to breaking point, we didn’t have any capacity before the coronavirus turned everything upside down, so to have to take on board yet more effort has been tough for everybody. Nobody is immune from the stresses and strains.”

Getting used to new ways of working, rapid technology deployment, distancing rules, PPE requirements…the list of pressures reported by practice managers is seemingly endless, and that’s before we mention the expanded flu vaccination season! With this in mind – and ahead of a Practice Index Podcast on the topic – how are practice managers coping with the current situation and the additional pressures?

“With difficulty,” one PM told us with a wry smile. “It has been a real rollercoaster of a year so far which has impacted everyone. We all have mental health, and whatever our circumstances, this outbreak is having an impact on how we think and feel about ourselves and the world we live in. I’ve had a partner crying on my shoulder one day, a receptionist the next, so if there is a positive to come from all of this it’s that we have become closer as a team. Everybody has pulled together and is mucking in where needed. It’s the only way we have got through this.”

Pulling together

Camaraderie and collaboration are two of the most common themes we’ve heard when researching for this blog – with practice teams working together to get through the pandemic.

“Throughout our response to the pandemic it has been interesting to see how people are prepared to put their hand up and help,” another PM commented. “Different people have struggled at different times and to varying degrees, but everybody has been prepared to stand up and help at some stage.

“We had a nurse who lost her parents to the virus very early on, which obviously knocked her for six. The team rallied around to support her and, now she’s back, the commitment to pay back that support has been clear. We’ve had another young member of the reception team – normally one of the quieter people here – who really helped us get to grips with Microsoft Teams – setting up quizzes and weekly socials. That has been priceless in helping us cope, along with being empathetic and accepting that everybody has and/or will be impacted. You have to be sympathetic, within reason.”

Irritable patients and rising numbers of complaints have also been an issue, especially it seems after lockdown restrictions were eased.

“Everybody seems to be so angry!” a PM laughed. “People we know well have suddenly become monsters! They’re grumbling about everything. We’ve had to deal with an awful lot, which we’ve managed by sharing the complaints and dealing with them as a team. By doing this it has further boosted our team spirit – we often have a good laugh about some of the petty complaints – and it allows us to brainstorm ways to improve or deal with any problems that need sorting. It’s a policy we’ll continue with going forward.”

A GP partner that we spoke to also talked about how the team at their practice has gone above and beyond to help. “People have worked overtime without questioning it,” he said. “At times we’ve definitely had issues with change fatigue, given the volume of technology and new procedures we’ve had to put in place, but we’ve got some team members who have gone the extra mile. They’ve written ‘how-to’ sheets to help patients get to grips with remote consultations and have even helped individuals get online through phone calls. It has been fabulous to see.”

Repaying the favour

According to the GP we spoke to and his practice manager, the key to success in their practice – a suburban south west London practice – has been giving back to people, especially as the pandemic continues to roll on.

“There was a sense of adrenaline, excitement almost at the beginning of the pandemic as change was happening at breakneck speed. However, I think it has become tougher for people as time has gone on.

“We’ve seen a reduction in the number of appointments being booked, so we’ve been able to increase time off in lieu and holiday allowance, for example, to give something back, to make it clear we haven’t forgotten the efforts put in place back in February, March and so on. We’ve also increased sick pay to reassure our team members – many were scared of losing income if they contracted COVID-19 so we’ve said we’ll cover a couple of weeks. We’ve also added flexibility around working hours, provided access to a mental health helpline and set up a phone system that enables calls to be fielded at home. Above all else though, we’ve coped by communicating and ensuring we’ve done everything we can to provide PPE and introduce procedures that keep everybody safe.”

Communication the key

As well as the PPE and safety of staff, as mentioned there, communication has been vital in coping with COVID-19. “As we continue to work through the pandemic  communication has remained front and centre of our coping mechanism,” a PM from a practice in Liverpool commented.

“We as leaders have – and will continue to – update staff on any and all changes that take place. Information is wealth at a time like this. It’s crucial that management is transparent about what decisions are being taken and expectations of all employees throughout this trying time.

“It’s also crucial you make sure people know where they go and who they talk to internally if they’re struggling and we’ve reiterated continually how to access support services that we make available.

“We’ve also encouraged people to maintain informal conversations too, via Zoom or Teams etc. This has been particularly helpful for a member of our team who has been shielding as they are 73 and diabetic! We’ve tried video calls, sent flowers on birthdays, arranged food deliveries so we can have special lunches – I see all of this as effective communication.”

Don’t forget yourself

While the above only scratches the surface of the ways practice managers and practice staff have coped with the COVID-19 pressures there’s one final person to talk about – you!

“The pressure has been difficult to deal with,” according to a PM. “I found a really good resource on the Mind website that shared some insights specifically for key workers and how they can deal with the stress of going into work. I actually spoke to somebody at Mind who suggested I should deal with the pressures by blocking out time away from the practice. I play golf, so I’m now booking an afternoon out every week, turning my phone off and getting out on the course. It has been brilliantly cathartic.

“I’ve also been having weekly get-togethers with the team – anybody is free to join – where we just talk about anything but the pandemic and the practice – they’re banned! I’ve learned more about football in the last six months than I ever thought I would! It has also been good talking to fellow PMs from other practices, to share ideas and resources.

“Finally, I’ve been lucky enough to lean on my family. My wife and children – all in their early 20s – have provided great support and helped me rest, which is probably the number one thing we all need right now!”

To support your entire practice team, Practice Index offer a free of charge eLearning module on Mental Health in the Workplace. The course offers advice and tips on identifying when colleagues are struggling with tips and managing your own mental health. During a turbulent and unpredictable year, it has never been more important to ask for help when you need it.

How are you coping with Covid-19 pressures and demands? Let us know by commenting below or join the conversation on the Practice Index Forum.