Ensuring a successful practice restructure

Healthcare is under pressure. When operational capabilities are outgrown by demand it might be time to think about a restructure. What this means for your practice depends on its particular needs but, regardless of the challenges, there are certain pre-requisites or crucial elements of any restructuring process. We explore the signs that show a restructure is needed and what you need to consider in order to ensure that it’s successful

Many healthcare providers in the UK are undergoing major restructuring – and with good reason. The need to restructure your practice from time-to-time is something that is so often overlooked. Practices can end up fire-fighting the symptoms rather than trying to fully understand and fix underlying structural problems.

It goes without saying that restructuring is a must when demand on your services has outgrown your operational capabilities. As general practice continues to drive forward under the immense pressure of an increasing patient population with more complex needs – alongside a squeeze on funding – looking at how you can achieve operational efficiencies is a must. One way forward is a restructure.

Common signs that restructuring is necessary

Here are some common indications that it might be time to restructure:

• Your management is full of fantastic ideas for improving the practice but a lack of staff is holding you back.
• Guidelines and protocols are not being followed to specification by all members of staff – across multiple sites, where applicable.
• You are constantly giving directions to your staff to do things in a particular way but they either cannot, or simply do not, follow through.
• Patient and staff satisfaction levels decline.
• You continue to add more responsibilities to some of your staff’s current duties because everybody is overloaded with too much work already.

Ensuring a successful restructure

Regardless of the unique challenges you’re currently facing, here are a few common prerequisites you need to consider in order to ensure a successful restructure.

• Align your practice strategy (or development plan) with the restructure

Aligning your restructure with your strategy may seem self-evident; however, you’d be surprised how many healthcare organisations overlook this. For instance, if your strategy includes engaging your local community, and growing your practice’s patient list, a focus on marketing and sales will be necessary. You should consider your staff’s skillset and focus on CPD to upskill existing staff to be able to fulfil this role – or consider creating a new role.

• Cut down unnecessary complexity

There is no better way to put this – undue complexity in your practice structure means extra costs and a major drag on performance. Mitigate complexity by:

• Minimising the use of matrices; having two or more lines of command or responsibility running through one person can muddy-up directions given to staff and introduce unecessary complication of tasks.
• Keep your staff structure ‘strategy-focused’, rather than working around specific personnel; politics are a part of the game, which is why it’s all the more important to work on clear and transparent structuring which syncs with your strategy.
• Avoid making leadership roles more complex than they have to be (outlined below).

Find a balance between your load and that of managers

Managers can lose focus on leadership duties when they’re expected to meet excessively high output requirements; this kind of ‘management loading’ can prove problematic in restructures. For instance, time and resources which go into staff coaching can drop off – staff can become disconnected and more staff errors arise while managers work feverishly to resolve them. Balance these three elements to ensure proper management loading:

• the number of personnel directly managed;
• your personnel’s ability to perform without supervision;
• the ‘own workload’ managers are expected to handle in addition to their leadership activities.

Learn how to read the indicators of restructuring and you can ensure continued success while effectively utilising all resources at your disposal. Do consider your practice’s unique circumstances – although the above key elements should act as a good restructuring compass.

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