According to a survey commissioned by Virgin in 2015 more than half (51%) of full time workers in the UK suffer burnout or anxiety – a figure likely to be higher in general practice. Here Marie Cahalane explores the support practice managers can offer colleagues at risk of burnout
Let’s talk about stress. The UK workforce is feeling the strain and, according to a BMA poll of general practitioners, nowhere is this more prevalent than in general practice. And it’s not just GPs who are affected. Faced with mounting pressures, which include increased workloads, funding cuts and rising patient lists, existing services cannot meet demand, a reality that’s draining morale and threatening burnout across board.
Enter the practice manager (PM). Occupying a central position within the practice, the onus often falls on you to take responsibility for the wellbeing of colleagues. So, as prevention is better than cure, what can practice managers do to alleviate pressure and minimise risk of burnout?
What is burnout?
Burnout isn’t merely feeling stressed or tired, or being a bit moody or frustrated. Burnout is physical, emotional and mental exhaustion leading to de-personalisation, low productivity and feelings of low achievement. In a word: meltdown. It occurs after prolonged exposure to unmanageable stress and affects people differently; in most cases, the last person to recognise burnout is the person suffering from it.
Dealing with burnout is difficult but having a strong and open support system within the practice is crucial to managing it. An important way of effectively managing this, says Claire Deare, development manager at the Leicestershire Leicester Rutland (LLR) Local Medical Committee (LMC), is “to actually help people understand that they are burnt-out and need to talk to someone”.
“The role of management in general practice has expanded in recent years as practices have to operate in a challenging environment, with greater regulation and scrutiny, and working within wider systems, often in collaboration with different practices and services,” says Dr Chaand Nagpaul, chair of the British Medical Association’s (BMA) General Practitioners Committee (GPC).
“Practices need increased resources to secure stronger, more effective and fit-for-purpose management – which can sometimes be shared across practices – to avoid this escalating workload and onerous responsibility falling on the shoulders of GPs at risk of, or already suffering, burnout.” As it stands, it falls to the PM to manage staff wellbeing of colleagues with the limited resources currently available.
Moving in the right circles
Alexis Hutson of Coaching Doctors agrees that as practices have grown “…so too has the workforce PMs are responsible for and the responsibility PMs have within their role to do the right thing for the practice, patients and staff”.
With limited resources available, Alexis recommends that PMs, and other staff, join support networks outside of the organisation. She believes that within these, long-standing PMs can help newer ones by sharing experience and knowledge around effective business management practices, but also how to manage people and alleviate stress.
Claire additionally suggests mentoring schemes – available through your LMC – as a means of bringing fresh insights and new support networks into the practice. Mentoring (either as a mentor or mentee) is an opportunity to discuss specific problems, gain alternative insights and benefit from an “external confidential perspective”.
It lifts the weight off an individual by helping them to make a connection, as she observes: “Sometimes just going to a meeting and hearing other people talking about problems and knowing that others are experiencing the same issues as you is actually quite helpful.”
Most practices are fairly close-knit environments says Alexis. “You have this small, intense group of people – it’s like a family in a way – so teamwork, group dynamic and organisational focus become incredibly important. The PM is at the heart of all of that.”
Yet, within this, staff often work in isolated silos, as Claire points out, which means that workloads aren’t shared. So the challenge for PMs is to get people to work with a focus across the whole organisation. Using the premise of external networks, Alexis suggests PMs create internal networks to combat silo working by “…developing your people, not in the existing roles they have within the organisation (as nurses, for example) but to think about individuals as having other qualities, attributes or skills that might be transferable or of interest across the organisation”.
She elaborates: “About three weeks ago I ran an away day for a practice in Leicestershire. We did a practice development afternoon on people getting to know each other, building trust and understanding more about who they are as people, rather than just through the role they fill. It was really helpful because we often make assumptions about each other that are wrong and which can lead to miscommunication, unnecessary conflict or difficulties, assumptions or opinions formed about teams or people which just get in the way of us working effectively with one another.”
Invest in your people as people
While an away day like this may be difficult to emulate within the parameters of job remits Alexis says it’s helpful to think laterally and get people working with each other on wider practice problems.
Viewing people independent of their roles adds a human dynamic and lifts people from the doldrums of everyday working life by creating social, rather than solely professional, relationships. It encourages a united front when dealing with issues within the practice; the burden is spread more evenly and not just by job title. This goes a long way to restoring work-life balance and promotes a social, fun side to work.
The benefit of this, as Alexis points out, is that “…when the proverbial does hit the fan you’re on much more solid ground with each other because it doesn’t matter what systems, processes or mechanisms you have in place, it’s actually the human relationships that matter in the end”.
Claire observes that “…changes, in terms of federations and a move towards getting practices to work together more closely…” are a real opportunity to focus on connecting people and creating a network of support that’s accessible when needed.
Make your practice an open community where people work together, talk to and support one another. Take advantage of mentoring schemes; your LMC will have resources to be tapped into and they’ll offer pastoral and personal support too, be that in terms of mentoring, a listening ear, friendly advice or information on useful resources.
The bottom line is: establish and encourage networks of support that extend beyond the perimeters of the practice, invest in people, nurture skills and share the burden. Remember that we’re all human and sometimes just listening and quietly understanding can be enough to lighten the load and spare your colleague, or yourself, from burnout.
This article first appeared in a previous issue of Practice Business