General Practice (GP) Doctor surgeries are an example of an ever changing business operation. This is why AB Commercial HR Solutions are around to offer a helping hand to General Practice Doctor Surgeries.
Most GP Doctor surgeries either operate as a Limited Company or as a Partnership and have the usual commercial business issues to wrestle with on a day to day basis – finance, accounts, compliance, audits, IT, premises and property management and HR.
GP Doctor surgeries do not access HR support through the NHS but as most surgeries have quite large numbers of employees, they are not exempt from having HR and people issues in much the same way as any other normal commercial small or medium sized business.
AB Commercial HR Solutions help General Practice Doctor Surgeries as they have extensive experience of working with GP Doctor surgeries providing a wide range of HR support including assisting with disciplinary issues, grievances, ill health management, absence management, TUPE, redundancy and issues associated with terms and conditions of employment.
Many General Practice Doctor surgeries have had to change their opening hours in recent years, providing sessions that start earlier in the morning as well as offering appointments in the evening or on Saturday mornings. This causes many issues with rostering reception staff and often variations to their terms and conditions, in turn causing further issues because this may impact family and child care arrangements.
AB Commercial HR Solutions have worked with many surgeries providing support regarding changes to terms and conditions as well as the introduction of new shift rostering arrangements to accommodate longer opening hours.
A further significant development over the last few years has been an increasing trend for GP Doctor surgeries to merge forming a much larger practice. This process is not without its HR challenges because when two practices merge it can result in a re-structure of the non-clinical team which is often managed by either a Practice Manager or, in some cases a Business Manager.
Also, when two Practices merge, it is possible that the newly merged practice will only need one Practice Manager and this can lead to a possible redundancy situation. In some situations, it can lead to the development of an entirely new role and whilst the existing Practice Managers may apply for the new role, they will not necessarily be successful and the partners may prefer to recruit externally.
Often, further re-structure is required and there can be challenges when two practices merge and there may be different cultures and each practice can be quite territorial. Also, different practices will have different terms and conditions.
New commissioning and contracting models, regulatory frameworks and the work of business improvement teams within NHS England means that General Practice must continually change in order to survive and AB Commercial HR Solutions has excellent insight into delivering cost effective, profitable service delivery.
The future of General Practice is changing and shared back office support or practice merger is likely to become more common as surgeries struggle with the financial challenges.
AB HR Solutions has worked with many surgeries during the merger process and often this can involve managing the demands and expectations of a group of partners who have significant personal interest. Often, one of the partners will own the premises.
The Practice Manager is a business critical role in the GP surgery – its brief covers finance, HR, IT, compliance, audits, property and premises management, organising reception rosters and it is not uncommon for a Practice Manager to have long service and many will have started with the practice as a receptionist and enjoyed gradual progression over a long time. They can be quite formidable characters.
There is also a perception that some Practice Managers are quite protective of the functions under their control, fiercely defensive of their role and resistant to change. In some extreme situations, the Partners are almost afraid of their Practice Manager!
But, nonetheless, GP Doctor surgeries still have all the usual HR challenges to deal with – absence and lateness, disciplinary issues, grievances raised by employees – sometimes against a GP and performance management issues where an employee is not managing with the demands of the job and sometimes this leads to a disciplinary or capability hearing, which may result in dismissal.
Also, GP surgeries are not without their challenges with employees who have mental health issues. Receptionists have to be quite resilient and not everyone is suited to the pace and demands of the environment where patients verbally abuse the Receptionist in open forum because they can’t get an appointment or a repeat prescription. It is not uncommon for these exchanges to lead to an employee being signed off with stress.
Partners and Doctors in General Practice do not relish the HR aspect of their job. They are clinical experts and whilst they have been trained to give some very bad news to patients, they can be quite uncomfortable sitting in front of an employee with 10 years service to tell them that their role is redundant due to a re-structure. Also, Partners are keen that HR issues are managed carefully, sensitively and professionally because if a disgruntled employee decides to go to the local press, this can lead to considerable reputational damage to the Partners and the surgery. It happens quite often……
Also, in some remote areas of Devon and Cornwall, GP Doctor surgeries are often quite rural and jobs in surgeries are quite highly sought after because of the perceived sense of security (and NHS pension) and the Practice Manager and local GPs are all held in high esteem in the local community.
In summary, Adrian has been working with GP Doctor surgeries for many years and understands the commercial dynamics of their business and can:
- Support with practice mergers and shared services collaborative working between surgeries.
- Advise on terms and conditions and employment contract issues.
- Develop and/or review contracts of employment, employee handbooks, policies and procedures.
- Manging change including contract variation, redundancy and re-structuring.
- Provide coaching and mentoring to Practice and Business Managers on HR issues
After working with a GP Surgery that had gone through considerable change as a result of a merger, creating a practice with 7 GP partners, 2 locations, 18,000 patients and over 40 employees, Adrian received the following note from one of the Partners.
“I do want to thank you though as your role in helping us to get here has been very important, your advice has always been very sensible and authoritative, ensuring that there was always a way forward, even when within the partnership we could not always agree amongst ourselves. You have guided us through a very sticky phase, and helped us coming out stronger on the other side”.
