According to a recent survey by the BMA, GP morale remains in decline and is lower than any other branch of medicine. GPs in the survey of 451 doctors, conducted last December, scored an average of just 2.2 out of 5 for morale, down from 2.6 a year earlier.
However, while GP morale grabs the headlines, what about practice staff? Most practice managers will admit that the low morale of practice staff is a ticking time bomb for most surgeries and a recent report by The Kings Fund showed that NHS managers had identified staff morale as one of their top three causes for concern.
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. With this in mind, what can practice managers do to boost the mood amongst staff?
Recognise low morale
For most practice managers the first step in dealing with low staff morale is to recognise the employees who may be vulnerable. Common signs include lots of whispering among small groups of staff, poor timekeeping and the following tell-tale comments:
- ‘I feel like I have no voice’
- ‘Although I am vocal, I don’t feel like I am being listened to’
- ‘I feel under-appreciated’
- ‘I feel unstable as there have been many changes in the workplace’
Praise, praise, praise
Once low morale has been identified the next step is to ensure staff and partners feel valued – and part of the team. 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.
Practice staff will most likely welcome the opportunity to air their views. If they feel under-appreciated and ignored, ensure you give them a voice and allow it to be heard. Running a staff survey allows you to rate and review all the different aspects of the workplace to ensure it is a motivating environment to work in. Asking employees what they believe to be the most difficult parts of their job will give you some interesting insights and ideas on how the areas highlighted can be improved.
If you also ask about each member of staff’s individual roles, points to raise could include:
- How the employee feels they are performing, and where their strengths lie.
- A review of any key projects the employee was involved in, and their results.
- A review of previous development objectives and whether they have been reached.
- Areas where the employee could improve and ways to demonstrate improvement.
- A series of objectives for the following year.
- Identifying any training or support needed.
You could also consider adding in an ‘ideas or improvement session’ in to regular team meetings to allow staff to voice their opinions. Knowing there is a regular forum for voicing annoyances and problems will make staff feel engaged and integral to the practice. In turn, this encourages team work and staff cohesion.
Staff should be encouraged to participate in new projects and operations that the practice is involved in. It’s great if you can match the skills and the interests of your employees with the needs of the role. So, instead of simply choosing the first person in your eye line, choose the person whose personal development will benefit from being given extra responsibility and who you think will excel at the job.
Enthusiastic leadership is crucial when maintaining staff motivation – especially when change is being implemented. Engage staff to participate in making changes with you and integrate them in the process, so they can see first-hand the benefits they are helping to realise.
Look beyond the person
Morale isn’t always linked directly to staff relationships – it can be often be more to do with the wider practice. After all, unhappy patients can cut morale down to rock bottom in one negative conversation.
As part of the Productive General Practice Programme, members of the Patient Participation Group at Thorpe-le-Soken Surgery in Essex 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. The benefit here is that you are made to stop and evaluate scientifically what you are doing and make changes that improve 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 wellbeing – along with the resulting happier patients.
Beer and biscuits
And finally, don’t forget the odd bit of socialising after work and a sweet treat or two at coffee break time – it might sound simple but a treat every now and again (do it too often and it becomes the norm) can work wonders in lifting spirits.
How do you ensure morale is maintained? What should the NHS be doing to support practices and help lift morale? Let us know by commenting below or discuss in the forum.