It was quite a year for general practice, with recovery from Covid being made harder by workforce, financial and media pressures. Throughout the year, our Practice Manager Panel focussed on the key issues facing practices, while also approaching things with, as described by Robyn Clark by last January, a “focus on the positive”. Here’s a quick reminder of everything the panel covered in 2022.

Workforce pressures were a constant issue throughout the year, and this was the focus for the panel as early as January (listen here). It has become much more difficult to attract staff at all levels into general practice, and our panel offered great advice on how practices can stand out in the local labour market and how they can keep hold of the staff they already have. The panel explored the possibility of more joint working between practices – for example, through shared administration staff or even operating as ‘hub and spoke’ models across PCNs.

Of course, it’s not just about staff recruitment and retention. With the huge influx of ARRS staff, many practices simply don’t have enough space for everyone. In February, Nicola was joined by Dr Hussain Gandhi and they worked through the practical steps that practices can take to make the most of the space they have (listen here). They talked about embracing remote working for the long term, particularly any work that isn’t directly patient facing, and even considered moving back-office teams off-site.

The workforce crisis continues to have very real consequences. In June, the panel, along with resilience expert Dr Rachel Morris, discussed the distressing (although not that unusual) case of a single-handed GP having to cancel their annual leave because they couldn’t secure a locum (listen here). The answer to this problem didn’t really lie in better organisation and forward planning (because no matter how well we plan, we all get let down at the last minute), but rather in more strategic solutions. The panel wondered whether, ultimately, being able to secure annual leave required more collaboration with other practices, or even mergers, to create a larger critical mass of GPs to build resilience.

Earlier last year, Russia began its invasion of Ukraine, and the influx of migrants seeking refuge from the conflict prompted our panel in March to interview Yusuf and Janet from Doctors of the World (listen here). They shared the huge challenges that some patients, including refugees, asylum seekers and people experiencing homelessness, experience in registering with a GP practice. They outlined the Doctors of the World Safe Surgeries initiative, which provides a toolkit, practical resources and a professional training programme for practice staff.

In May, the panel turned its attention to the barriers that the trans and non-binary community encounter when accessing healthcare (listen here). The IGPM, Practice Index, Pride in Practice, and the Indigo Gender Service have produced the Gender Identity Toolkit for practices, and the panel highlighted the usefulness of the document for GP practices – in particular whenever one of their patients wants to change their name or gender marker.

Another group of people who struggle to access healthcare (and general practice specifically) are military veterans. In August (listen here), we were joined by two special guests, RCGP Veterans Champion Brigadier Robin Simpson and military veteran Darren Davies, who explained the issues military veterans face and how we in primary care can ensure there is better support for them. They praised the RCGP veteran friendly GP Practice Accreditation, a fantastic initiative through which practices can be accredited as ‘veteran friendly’ (and which you can still sign up for!).

The IGPM Directors announced in July (listen here) that professional recognition for practice managers was finally on its way with the introduction of formal accreditation for practice managers. This marks a huge step forward for practice managers who are finally being recognised as a profession in their own right. Since its launch, over 200 practice managers have either applied for or already received accreditation. At this rate, it may even be the first step toward a Royal College of Practice Management!

During 2022, the cost of living rose at an alarming rate. Inflation started the year below 5%, but had risen as high as 10% by the autumn. This has had huge implications for practices, as our panel outlined in September (listen here). Funding rises are locked at the 2019 contract agreed rate of 2.1%; meanwhile, NHS staff pay rises are more than double this (4.5%), making staff retention in general practice, as we discussed in January, more difficult than ever. Throw in the energy price rises and our panel started to question whether this might even affect the ability of some practices to continue.

Liz Truss may only have been Prime Minister for 45 days, but general practice wasn’t able to escape the impact of her disastrous tenure. During that period, a “plan” for the NHS was announced, which included a promise that patients could be seen within two weeks by their GP whenever they wished. In October, our panel was understandably frustrated by this lack of support, and decried the media’s comments about general practice, which only made matters worse, just as winter pressures were looming (listen here).

It was probably no surprise, then, given all the pressure that practices have been under this year, that keeping staff motivated has been challenging. In November, HR expert Susi O’Brien joined the panel to talk about a new phenomenon known as “quiet quitting” (listen here). This is where employees decide not to go the extra mile when at work, and only do the bare minimum to meet what’s in their job description. Some practices are starting to experience this, and the panel discussed how this behaviour can be prevented, in particular by making sure staff feel valued and engaged.

What a year! The panel will be back throughout 2023. Do let us know if there are any topics you’d like the panel to cover this year. Let’s hope it’s a much kinder year for general practice.

Big thanks to everyone who has participated on the panel, in particular Nicola Davies and Robyn Clark who generously share their expertise, time and passion for general practice, and thanks to all of you for listening.