Management in Practice spoke with Dr Karen Forshaw, a GP in Doncaster, and physiotherapist Chrissie Mowbray, who are set to speak at Management In Practice London on 14 September, the title’s first face-to-face event since the Covid-19 pandemic began.

Dr Forshaw and Ms Mowbray are co-authors of How to Rise – A Complete Resilience Manual.

What does resilience mean in general practice, and how has that changed during the pandemic?

Dr Karen Forshaw: Our definition of resilience is the ability to bounce back from adverse events. In the context of general practice, it is the kind of experiences that people have when they’re working in that kind of high-pressure environment with people who are maybe a little bit afraid [or] sometimes a bit aggressive.

The adverse events we would be talking about in that context would be around confrontation with patients, confrontation with other staff, complaints, or dealing with when somebody actually collapses in the surgery. Often, it’s the reception staff that are the first ones to see that kind of thing. It is about those kinds of experiences, and the ability to come to work the next day and be okay.

During the pandemic, initially we saw a massive decrease in patients coming to the surgery.

I think there’s not as much understanding from patients now. People are tired of being dealt with over the phone. They want to get back to face to face, and that is potentially difficult.

Chrissie Mowbray: I think the service is being scapegoated in the way that people are feeling frustrated. People are expressing their frustrations in my clinic that they are not being seen fast enough, or not being seen in person but being called in it if it’s something to look at. I’ve seen it on Twitter, I’ve seen it on social media: GPs being attacked really for the way things have had to go.

Do patients expect a certain level of resilience from their practice staff?

KF: I’m not sure patients think about staff at all. If you’re a bit worried that you might have a serious illness, it makes you afraid, and that actually makes you quite blinkered.

You don’t necessarily think about what you’re saying. You don’t think about the impact that you’re having on other patients. You just want what you want, and you want it right now.

What impact has abuse via social media had on staff wellbeing?

CM: It really is evidence for what Karen was saying that the patient isn’t thinking about the practitioner as a human being at all. They’re complaining about the service, and that leads to dents in people’s resilience.

Nobody holds back, and on social media you’re not actually speaking to a person – you’re just venting, and that gives a collective feeling of not being appreciated; not being valued as a service.

KF: It’s about making sure [staff] recognise that actually, what patients are complaining about is the situation, as opposed to you as a person. And therefore, making sure your response is more measured, as opposed to escalating conflict.

What can practice managers do to protect and reassure their staff?

KF:  It’s like a family at my surgery. [But it can be] hard for the practice manager to make sure that everybody’s okay [when they also face situations that require high resilience]. The most important thing is that they make sure they’re okay, because you can’t teach people to be resilient if you aren’t yourself.

You can’t pour from an empty cup. If you don’t have resilience skills yourself, how can you teach or expect your staff to have them?

Practice managers should really think about building their own individual skill sets because then they can teach those skills. They can facilitate situations or [good] practices in the surgery that mean their staff will develop them too.

For more information about the Management in Practice Events, please visit: https://www.managementinpractice-events.co.uk/