Our panel of leading PMs and GPs discuss how to deal with the problems that confront you at work. Compiled by Kaye McIntosh.
Dr Rajiv Kalia, clinical director at Great Barr & Handsworth Wood PCN, Birmingham
‘The amount of information and the speed at which things change has been one of the most challenging parts of managing this crisis. What you thought was correct when you spoke to a patient at 8.45am can be completely different by 3pm – for instance, which patients need to shield.
The first step is getting the right information given the volume via email, Twitter, WhatsApp or Facebook. For me my trusted sources include a brilliant compilation of information from Stephanie Coughlin as well as Primary Care Pathways. I have Red Whale updates via email (which are free) and our STP sends a daily email to Covid-19 champions in each practice.
I’m a clinical director and our CCG have daily MS Teams calls, which have been insightful. It may be wise asking if you can listen in on your local equivalent. These normally last an hour a day for us. There are also weekly webinars from the brilliant Nikki Kanani, Medical Director of Primary Care for NHS England and NHS Improvement,but I don’t think I have enough brain capacity for it all!
I have found WhatsApp the quickest and easiest way to get information out to staff and practices. It’s useful to make sure people have the information at their fingertips when they need it. We also have daily Covid debriefs with clinical and admin staff. This gives them a daily opportunity to hear all the latest information and changes we have made, but also for staff to feedback issues they have had.
Given the level of exposure to Covid-19, people are very scared. Giving them as much information as possible has helped to empower them and appreciate we are doing all we can to protect them and their families. I trust our practice staff with documents direct from NHSE – it’s sometimes great to get a fresh pair of eyes. It can also change your internal processes, e.g. our staff were keen to start temperature checks on all patients and staff. They put into place the process and monitor this daily.’
Michelle Barksby, practice manager at Sherwood Medical Partnership in Mansfield, Nottinghamshire
‘Covid-19 has created an uncertain environment, where policy and guidance are evolving so quickly that we’re running to stand still, more now than ever. As managers this can be disconcerting when your team is looking to you for guidance. The frequency of change can make you feel at times overwhelmed and out of your depth. How can you manage to stay up to date while balancing the other elements of your role and update your team and implement the required changes in a timely way?
First, take a breath. Your practice service delivery is likely to be unrecognisable from a month ago. At this moment in what will become history we are all feeling the weight of the uncertainty and ambiguity of the situation. What’s important is how you move forward.
Try to select a small number of official streams of guidance, such as the Government website, NHS England/Scotland/Wales, your CCG and LMC. Keep up to date with these to stay well informed and allow you to share the relevant information with your team.
Avoid possibly misleading sources of information – social media groups can be helpful but they can also be sources of anxiety when a well-meaning post at 11:30pm has you awake all night for something that, in the light of day, has been misunderstood.
Your approach should be tailored to your team size. With smaller teams it’s may be easier to do regular face-to-face meetings, but this may be impractical in larger practices with multiple sites. Agree on a specific channel for communicating with your team. It may be a 10-minute stand up meeting at the start of the day or via a daily notification through the clinical system, but be consistent – staff will begin to rely upon this update and look to it as a steer through the ever-changing environment.
Try to distil information into bullet points to ensure that messages are captured and conveyed. Time is short and long messages are less likely to be effectively digested. If possible, try to back up with some element of meeting face-to-face, even if it’s in small groups less regularly. Staff teams are feeling vulnerable right now, and eager for guidance.
Often face-to-face reassurance even via video calls reiterating messages you’ve already shared via email and giving the opportunity to ask questions is enough. Seek to provide support and reassurance being honest with staff about the challenges ahead but remind them that by working together the team is stronger.
Above all, acknowledge that this is beyond anything anyone has dealt with before and that we’re all feeling our way through this. Apply what you know about your own practice and teams to good effect, drawing in turn on their support.’
Nick Nurden, business manager at The Ridge practice in Bradford, West Yorkshire
‘The volume and detail of information that is being provided is excellent and has been very helpful in guiding us on how best to adapt and change our services to keep. But there is so much information that it requires between two to three hours of time each day just reading and absorbing all that has been sent. Then it needs to be discussed in the practice and acted on. It often comes to us from several different sources – the CCG, NHS England and the LMC among others. Information is often duplicated and keeping up with the latest version can be tricky.
At an early stage in the crisis, we asked all staff to stop circulating information that they received. This included things that were being published on social media (with varying degrees on accuracy and helpfulness). We nominated one GP as a lead for all Covid-19 information and provided him the time to sift through and distil what needed to be passed on and what had changed since yesterday.
Early on, we developed an overall practice protocol covering all areas of operation – GP appointments, nursing work, protocols for reception and admin staff – with all information based in a single document. The relevant and important documents are embedded within, or linked from, the main document. This overall protocol is then updated and recirculated as often as needed – normally every couple of days – and becomes the single point of reference for all staff.
While things were changing so quickly we instigated a daily practice meeting at 7.45am to brief all managers and staff on what had changed since yesterday, and for us to review how things had gone yesterday and what we needed to do differently to keep things running smoothly and effectively for our patients. This has been working well and enabled the whole team to keep up to date and working to the latest guidance.’