Low morale in in healthcare once again hit the headlines this week after a General Medical Council report warned that the situation with doctors has reached the point where patients are being put at risk. The regulator said there was “a state of unease within the medical profession across the UK that risks affecting patients as well as doctors”.

While this report focused more on hospital-based doctors than on those in general practice, there’s no getting away from the fact that morale is extremely low across primary care as budgets are stretched, workloads increase and management from above seems to become more and more questionable.

The factors that are damaging morale are generally outside of the control of practices, so when it comes to any attempts to boost morale it’s important for practice managers to focus energy and resources on the areas that are within your ability to influence. After all, managers who are able to create a more positive work environment where the vast majority of team members are engaged in the success of the practice should see the benefits of reduced stress and absenteeism, alongside improved productivity.

Spot it early

Firstly, it’s worth bearing in mind, although we doubt you needed reminding, that low morale is totally understandable. Practice staff are faced with a working environment characterised by rising patient demand, falling resources, staff shortages and more unfunded care being moved from hospitals and into the community. Busy doesn’t always correlate with happiness or job satisfaction.

Spotting low morale is not terribly difficult. Those suffering are usually either apathetic or defensive. Apathetic staff members are characterised by low energy levels and a withdrawn demeanour. Defensiveness is often characterised by higher energy levels and an aggressive demeanour. No matter what low morale may look like in your practice, most of the time a sense of frustration and helplessness is manifest. Unplanned absences, workplace accidents and poor work quality are also warning signs that a general malaise may exist in the practice.

In a small business environment like a medical practice, morale takes on even greater importance. Most practices have little employee overlap and each member of staff has a specific set of assigned tasks. If several staff members are not fully engaged, the productivity impact may be felt in all other areas as engaged employees attempt to offset the marginalised staff. Over time, this can lead to mistakes and resentment.

Be honest

So what can you do to boost morale? The first thing is to swallow your pride and take a look at your own performance.

Most HR experts will tell you that ineffective or inconsistent leadership/management is the most common root cause of low morale. The work environment and culture of the team is often a reflection of the approach of the senior manager within an organisation. Most employees function better in an environment where there is a clearly defined set of goals and expectations. This is true for their specific tasks and for the practice in more general terms. Each staff member should have a documented job description that outlines all of the responsibilities and expectations of the position. Furthermore, the practice manager should provide each team member with an understanding of how their performance will be evaluated.

Empowerment, appreciation, consistency and responsiveness are other key areas of leadership. People like to believe that they are part of something larger than the tasks that they perform. Effective leaders will make that connection for team members and make certain that everyone in the organisation knows how the practice is performing against the goals that have been established.

Be interested

Employees want to feel loved. The simple act of inquiring how your team feels conveys the sense that they matter and that their opinions are important. Continuous communication is the best defence against morale slippage. Give credit where it’s due and try to praise staff to whoever will listen, and use social media to tell patients about all the good stuff you’re doing. It’s also worth letting people know how the hard work they’re putting in is being recognised and appreciated.

Team building events, both during and after work hours, bonuses for utilised suggestions, passing on of compliments, not just to the individual but to the whole team, and rewards for loyalty can all help to maintain morale. As can the simple act of buying the team a tin of sweets or pack of biscuits when the going gets tough, or ‘just because’.

Involve staff

Morale can also be boosted by making staff feel like part of the overall practice team – especially when changes to the practice need to be made. Consult with your team, explain what needs to happen and why – and ask for their input and act on comments – there’s no better way to make people feel involved.

A good example of how this approach can be used proactively comes from Thorpe-le-Soken Surgery in Essex. As part of its Productive General Practice Programme, members of the Patient Participation Group spoke to over 400 patients. This one-to-one approach encouraged meaningful participation and disclosure of valuable, honest information which the practice used as a basis to understand which areas required attention.

This approach helped the practice to stop and evaluate scientifically what they were doing and make changes that improved the practice environment and the service offered to patients. Internal surveys undertaken at the start of the programme showed that staff felt stressed and were generally unhappy at work. As they progressed with implementation, a follow-up survey revealed a dramatic improvement in staff morale and contentment. Directly involving staff in changes and making them feel part of the process was identified as a major contributor to this change in staff mindset.

Morale is a big issue in practices for sure – and it can be tricky to constantly keep everybody happy – but by ensuring a few processes are in place and investing a little bit of time and a small amount of money, you can certainly go a long way to improving the situation.

How do you ensure morale is maintained? What tips can you share with your fellow practice managers? Let us know by commenting below or discuss it in the forum here.

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