GP in Wales and Management in Practice event speaker, Dr Anish Kotecha, shares why prioritising wellbeing is important for practices and how managers can make a difference in the day-to-day.
Why is burnout an important topic in general practice right now?
Primary care has always been a busy environment, but Covid has accelerated burnout, and equally it’s just brought the conversation of wellbeing to life a bit more.
Since Covid, the demands on general practice are higher and expectations from patients have risen. I don’t say that negatively, I think it’s partly because people have had to change the way they do things, such as accessing GPs through phone calls rather than face to face appointments, and increased waiting lists. Expectations have also grown with things now opening up a bit more. So, I think primary care has just become busier.
Often, reception staff and practice managers have suffered the brunt of this and that’s had an adverse effect on practice teams.
Equally, the home environment has changed too. Since Covid, people are struggling with homeschooling too, for example, so there’s been pressure all around.
What are the key risks when GP and practice staff wellbeing isn’t given enough priority?
Ultimately, it’s patient safety. If you’re burnt out, then you’re not working at your maximum capacity. This can also lead to sickness absence, and mean you are less productive at work.
It’s also an issue because if one person feels stressed or has burnout, they can then ‘pass’ those negative feelings to other staff, who might have been feeling okay before. That staff member then goes, ‘Oh you’re right, it is hard work isn’t it here’. Very quickly, you can get three or four people feeling like they are struggling at work, who then end up going to the practice manager, which ultimately adds to their feelings of stress.
So, the problem is if there’s one person feeling burnout, it can have a ripple effect, and have negative consequences for productivity, absenteeism, sickness, and the stress levels of others.
What are the signs of burnout to look out for in your practice?
Emotional exhaustion, physical symptoms of anxiety or low mood, being short-tempered, and negative thoughts are a few.
Part of the issue with all these sorts of symptoms and signs is that people can put them down to being busy, or having to deal with an awkward patient or situation.
In reality though, a person can become a bit more cynical and negative because they’re exhausted. These should be the signs to look out for in yourself too. It’s important you reflect on how you’re feeling and make it a routine task every morning and evening. Ask yourself: am I doing okay? Do I need to change the way I’m doing this? It’s definitely about self-reflection.
How can you best support your practice staff?
Teams need to look out for and support each other. Not only when things have gone wrong but as part of the normal working day. It’s important to have regular check ins.
For example, the practice manager can say on a weekly basis: ‘Let’s get together and catch up and see how things are, we realise things are busy, thanks for everything you’re doing, and you’re doing a fantastic job.’ They should remind staff their door is open and to come and see them if they need anything.
Practice managers need someone who supports them in similar ways too. I always say that if the practice manager goes off then the surgery falls apart. They hold it all together. So, it’s about showing support for one another regularly.
How can PMs prioritise their own wellbeing?
We don’t tend to put checking our own wellbeing into routine practice. We say, ‘Oh yes wellbeing we need to think about that’, and then we focus on it for two or three months then, forget about it again.
So, for me, wellbeing is a continual process. It’s being aware that wellbeing needs to be somewhere on your list of daily or weekly check ins. That’s a check in with yourself, it’s a check in with someone at work, and it’s a check in with someone at home.
You need a network of people who you can go to for support when you need it. When I’ve had a bad day , I’ll go to someone at work who might be a mentor of mine and who I genuinely like catching up with – it could be a practice manager – because they understand the pressures of work. But equally, a couple of times a week I’ll say to my wife let’s sit down and have a coffee or chat after the kids have gone to bed. Building this into your day doesn’t require extra time and shouldn’t become a burden, it could just be during the 10 minutes you spend clearing the table after dinner, for example.
If you had to pick one thing practice managers could do to support GP wellbeing better, what would it be?
First, it’s got to be a two-way thing – if practice managers are supporting GPs, then GPs need to be offering support for practice managers.
Second, every GP is going to be different, what they want, need and how they feel about this is going to hugely vary. But a small thing to do that I think is important is to knock on people’s doors in the morning when you get into work and say, Hello, how are you doing?’ And then, before you go home, doing the same thing before saying goodbye.
It might not seem like much but it’s an acknowledgment that you are there if needed, and that’s quite useful and reassuring.
Working in a practice can feel a little lonely, and I always say to my colleagues that they’re my second family because that’s where I spend most of my time. A simple check in can open the door to a conversation.
