Could your practice benefit from an agile approach?

From managing budgetary pressures, to strains such as the ‘flu season or staff retention issues, GP practices face extraordinary challenges. Practice managers are responsible for keeping the business running in a high stakes environment, and need to have the tools to ensure everyone in the team is empowered to be flexible enough to handle the unpredictability that comes with working in the British healthcare sector.

Could adopting an ‘agile’ approach to management help you to cope better with the pressures you are facing? Paul Goddard, of Scrum Alliance, believes it can…

I have been helping businesses to streamline processes and engage everyone by fully adopting agile principles practices, and values. Developed as a method to manage complex development projects in the digital world, agile awareness is fast-growing in the UK, and yet, many are unclear still on what exactly ‘agile’ is and how it is relevant to their business. Here I want to share my expertise on the relevancy of agile to operations such as GP practices and provide some top tips to enable practice managers to begin the journey to realising agile transformation.

Firstly, what is ‘agile’?

‘Agile’ refers to a specific set of principles and values that foster the mind-set and skills businesses need to succeed in an uncertain and turbulent environment. The term ‘agile’, first coined back in 2001, encompasses a common set of principles laid down by the software development community.

‘Agile’ refers to a specific set of principles and values that foster the mind-set and skills businesses need to succeed in an uncertain and turbulent environment.

These principles – the basis of the Agile Manifesto – proposed a new approach to product development, setting out an alternative way of thinking when approaching a project in order to deliver higher quality products in a shorter timeframe.

The core values of the <em>Agile Manifesto</em>:
  • Individuals and interactions over processes and tools.
  • Working software over comprehensive documentation.
  • Customer collaboration over contract negotiation.
  • Responding to change over following a plan.


Agile may seem far removed from the, very human-focused, challenges of a GP practice. While, initially, the outcomes were focused on technology solutions, the framework and mind-set were so successful at tackling some of the most complicated business challenges that it has since won fans and adopters from a broad range of sectors from banking to boy scouts and, especially, HR.

Furthermore, scrum is an agile framework; an incredibly powerful set of principles and practices that enables cross-functional teams to deliver products and services in short cycles, enabling fast feedback, continual improvement, and rapid adaptation to change.

As practices struggle to retain doctors and nurses, in part due to increased ‘burnout’, agile and scrum are paths that allow staff to feel ownership over their jobs while boosting collaboration – all while maintaining an excellent standard of care for patients.

Agile and scrum are paths that allow staff to feel ownership over their jobs while boosting collaboration.

What is an agile transformation?

Agile transformation, in short, describes the metamorphosis of a company into a more adaptive, collaborative and effective business.

How does it work in practice? A coach works with the management and teams to break down complex projects into smaller, manageable pieces, which allows them to continuously deliver outcomes on a more frequent basis. When teams are working towards these tangible and rapid results, a more collaborative and flexible approach is fostered.

This approach will enable practice managers to continuously tailor and adapt a way of working that enables practice staff to collaborate, with minimal risk of them breaking down into ‘silos’, while being flexible enough to adapt to pressures of volume or complexity of patient issues. Furthermore, breaking down projects will empower staff to focus on what they are passionate about – seeing patients and providing excellent medical care.

One example of this is at Buurtzorg, a fully self-managed homecare organisation in the Netherlands. After adopting agile the team there could meet patients’ needs while using only 40% of the authorised patient care hours, compared with the average among other homecare organisations of about 70%. In addition, the company had lower overhead costs than other home-care providers (8% of total costs, compared with 25%) and less than half the average incidence of sick leave and employee turnover.

 For agile to be effective, everyone in the practice needs to be invested in adopting it. Here are some lessons I’ve learned about implementing a successful agile transformation.

3 tips for getting staff to engage with agile transformation:
  1. Don’t run before you can walk. Agile transformation is a challenging and on-going mindset to learn, so don’t try and change all your teams at once. Start with one core team, get a certified coach to teach them how to adopt agile in a way that works for them. It can then gradually expand to incorporate the whole GP practice from there.
  2. . Explain the personal benefits to doctors. Research in the Scrum Alliance State of Scrum Report shows that 87% of those who have adopted agile feel that it improves their quality of work life.
  3. Focus on the positive. If you believe that something can change it’s more likely to happen. Lean in with teams and individuals so that you can identify and address organisational impediments.

Managing a GP practice in today’s climate can seem like an overwhelming task. This means unpredictability and invaluable energy being pulled in multiple directions. Working with an agile mindset empowers everyone in the team – from management to doctors and receptionists – to take this uncertainty in their stride and have the tools to efficiently work through the management aspects of a GP practice.

Agile isn’t an instantaneous fix but, when adopted full-heartedly by a practice, it will help everyone to get back to doing what they love – practicing medicine – and focusing on the most important outcome, patient care.

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