Our panel of experts tackle the challenges that take up your time. Compiled by Kaye McIntosh
It’s hard to please everyone all of the time and staff rotas are one of the areas that I struggle with. I want to be flexible and give where I can but there are times when you do have to deny leave because of the needs of the business. I find being clear at the interview stage about expectations of flexibility is important – making sure that it’s in job descriptions, offer letters and policies.
We are a small practice and it means that there are times when everyone needs to do extra, including me. Although the other staff would rather I don’t cover reception as I create chaos! Willingness to lead and support pays dividends when I need to call on individuals to help. If I’ve managed to cover their needs, they are more likely to be flexible for me.
Honesty and openness are important. I give the team all the information and ask for their support filling shifts, and usually they manage to fix the problems for me. There are occasions when a manager needs to make unpopular decisions, but if you have a record of give and take, your staff should realise that you are fair and honest and will support you.
Kay Keane is practice manager at Alvanley Family Practice in Stockport, near Manchester
Getting it right in the first place is the best option – ask any practice manager who has been asked to change rotas at the last minute. To create a good rota, you need to be aware of three things: staff, time and your patients. Each of these will feature in a well-constructed system.
It must work for staff. GPs, locums and employees are all demanding. Start by finding out who wants to work when, for how long and where. If you can fulfil most of these requests, then you will have a happy workforce.
Although flexible and part-time working hours are attractive, generally most people do like the idea of consistency. If you find that many want to do the same hours or days, then extend the rota over a longer period and rotate staff hours consistently within that period. That way, each person may only need to do the least popular hours on a one-week-in-four basis.
Avoid over-staffing and creating unnecessary overtime. Conversely, recognise when staff are routinely exceeding their normal hours. General practice performs to a contract and can only provide a definitive number of appointments within this contracted sum. Identify this number and then start to understand what level of service you are providing above and beyond. Each appointment has a specified time and associated cost for its provision.
Lastly and most importantly, involve your patients. Include your Patient Participation Group in discussions. This will be beneficial in the long term. They can concentrate on dealing with patient access issues and you can concentrate on delivering the best service.
You should take control of the rota for the welfare of your staff. Consider the needs of your patients, but do not try and please everyone. There simply is not enough time available.
Steve Williams is co-chair of the Practice Management Network
This is a very challenging area and can end up taking vast amounts of time and effort. There are conflicting demands that complicate the process of developing a workable rota. Firstly, the contractual need to have enough staff available at the times we need to be open and answering the phones. We have to try and be flexible enough to vary this to meet the times of high patient demand (which are often the tricky times to ensure staff are available).
Secondly, we want to be flexible employers and support staff with their work life balance, fitting round the school run and giving them the holidays they would like. The trouble is the more flexible you are, the more challenging it is for you to work out the rotas. The key is to try and keep it simple. Wherever possible, have a regular shift pattern – for example morning shifts from 8.00 – 1.00 and afternoon shifts from 1.00 – 6.00 or similar.
In reality, to manage a service we have to be clear about what is required when we recruit staff and when they ask for changes as their circumstances change. This can be very challenging, but we need staff answering the phones at 8.00, so not all the team can start after school or nursery drop off.
Some can be reasonably accommodated if they are able to develop into other roles that are less time-dependent. There are no easy answers. Just try to keep it as simple as possible – this makes covering holidays much easier than if you have a complex pattern of shifts and different times. Be clear about expectations about working patterns and holiday cover from the start.
Daniel Vincent is managing partner at Ryalls Park Medical Centre, Yeovil, Somerset