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Practice manager, we need to talk ‘change’!

by in GP Practice Management

Change is a constant in this frantically fast-paced world of the NHS. (That’s the understatement of the week, Kara!)

So, by now, you’ll no doubt have started to enjoy the lighter evenings, sipping wine and reading the NHS Long Term Plan and Network Contract DES from cover to cover…


You know as well as I do that people aren’t big fans of change – not your team, not you (well, sometimes but it can be a bitter pill to swallow) and certainly not your patients.

When change is faced, communication matters. But a LOT of other tasks come along with change management too, like dotting the i’s and crossing the t’s on the legal stuff, crunching the numbers and shuffling the financial paperwork.

There’s plenty of legwork involved in making even the simplest of changes in a surgery.

Soon you’re tied in knots.

Even sooner, you’re fed up with it all.

Little wonder then that a clear and far-reaching communication plan can go out the window before you’ve even got started. So, here’s how to get it right (and why today is the day to get set for the rest of the year ahead).

Nail your organisational change and opportunity awaits

Over the coming months, practice managers will face one of the biggest shake-ups in the surgery structures in living memory. Get it right, and there’s potential for pressures being lifted from GPs and nurses, as well as decreased waiting times for patients. These two achievements are not to be underestimated; 32% of GPs are so stressed they feel they cannot cope at least once a week, while dissatisfaction in the NHS has risen to 29%, the highest in a decade. Among the primary drivers of this dissatisfaction is long waiting times. But getting it right is far simpler said than done…

60 70% of organisational change projects fail.

Hey brain, time to catch up with the 21st century! 

The brain remains a misunderstood and largely mystical organ. But what we do know is that it still processes many things in a primitive fashion – including our reaction to change, which can be perceived as a threat. Here’s the psychological stuff, as explained to me by someone much brainier than me…

  1. Sensory information is sent to the hippocampus
  2. Analysis happens quickly here – the hippocampus determines whether this situation has been experienced before
  3. If a situation has been experienced before and been linked to a negative experience, a fear response can be triggered
  4. The amygdala will capture the context of this experience for the future, recalling the emotions and physical sensations surrounding the event

Thanks, ancestors!

Needless to say, in order to counter this millennia-old pre-wired problem, you’re going to need a strategy.

Successful change management begins with solid internal communication

Without excellent internal communication, your team can feel uncertain and negative, and uncertainty and negativity are contagious in many GP surgeries. Here are our five fast tips for change management done right:

  • Be as clear as you can about what’s happening, why and when.
  • Encourage questions and open communication – even if it’s going to be painful.
  • Acknowledge the constant change your teams are grappling with.
  • Keep people (patients and team members) in the loop through multiple media – email, social media, posters in the waiting room or staff kitchen, leaflets, postcards, the staff newsletter, team meetings, etc.
  • Commit extra time and resources at the start of each new change phase. (Let’s dig into this now.)

DENIAL A.K.A. “La la la la laaaaa” (I can’t hear you!) 

During the denial phase, people need information to let their pesky amygdala know that it’s all going to be okay – or ‘reyt’ as we say here in Yorkshire. This isn’t like all those past experiences with negative, uncertain change.

There are five core questions they’ll need you to answer…

  1. What does the change entail?
  2. What are the goals of the change?
  3. Will their roles and teams be impacted, and if so, how?
  4. What is the time frame for the change?
  5. Where can they go to get help?

RESISTANCE is futile (but people will do it anyway)

Once denial is subsiding, in steps reaction. During this stage people feel anger, resentment and fear. Of the entire change curve, this is the one to be most wary of.

Begin by creating two objection lists – one for the team and one for your patients. Armed with these lists you can then create your responses. Tackle this with the management team and carefully plan how you’ll put forward a united message.

EXPLORATION – smile, calmer waters are (hopefully) ahead

This stage is all about acceptance. At this point your team and patients will begin to adapt to the change and explore what it means for their role or their life.

Support should be concrete (with training and information documents stored in a central location for staff), and direction must be given in a clear, step-by-step fashion.

Project-management software can provide a huge helping hand here, but if you don’t have any, give Meistertask or Trello a try – they’re free and great for getting stuff done.

COMMITMENT – Get your pom-poms out

This is the exciting part. Seeing your team or patients move from flat-out refusal to acceptance to being positive about it is massively rewarding. And it does happen in general practice, believe it or not. A lot. I’ve seen it with my own eyes.

But don’t count your chickens just yet. Your people and patients still need to be reassured that the change has been a productive step in the right direction. Tools for this could include smartphone videos, blogs, photos and team-building events.

Mayday, Mayday – danger ahead!

Like all best-laid plans, there’s always an iceberg waiting to pop out of the water sooner or later. Look out for these common warning signs of failing internal comms:

  1. You continually struggle to craft and deliver tough (but necessary) messages.
  2. Messages aren’t delivered in the right formats or through the right media – so employees or patients miss them entirely.
  3. Messages aren’t consistent.
  4. Messages aren’t delivered at the right time.
  5. Communication isn’t delivered by the right people – such as the practice manager delivering the first meeting when it might have been better for the patient manager to have handled it.

Ready to commit to solid change communication? Your team needs it; your patients need it even more. Get it right, and your practice could embrace the changes that are just around the corner for the betterment of all.

Kara Skehan (Yorkshire Medical Marketing) – Front-line friend to primary care. Champion of common sense and ‘reyt’ simple words. Kara is a healthcare marketing specialist living and working in Yorkshire.


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Practice Index

Practice Index

We are a dedicated team delivering news and free services to GP Practice Managers across the UK.

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