WPBA: Leadership activity and MSF

This activity involves reviewing how a practice works from the perspective of someone newly placed within the organisation. A GP registrar may identify strengths, opportunities for improvement or possible solutions to issues that have been difficult for the practice to address.

The process

• Soon after induction, the GP registrar is informed that they will be invited to present observations and recommendations to the practice team after an agreed period, such as approximately two months.
• During this period, the GP registrar observes how the practice works, including structural, cultural and operational factors.
• Useful prompts may include: what is working well; what is not working as well; why a process is done in a particular way; whether approaches seen elsewhere might be relevant; and how good practice within the organisation could be shared.
• The GP registrar identifies a small number of areas that may benefit from change and prepares recommendations.
• At a prearranged meeting, the GP registrar presents observations and explains the rationale for any suggested changes.
• If appropriate and time allows, the GP registrar may work with relevant colleagues to support implementation.

Intended outcomes

• Developing observational, analytical and influencing skills.
• Using evidence and practical examples to support recommendations.
• Understanding organisational culture and systems within general practice.
• Developing confidence in contributing to practice improvement as a member of the team.

GPs attend and often chair a range of meetings. This activity gives GP registrars an opportunity to develop skills in agenda management, inclusive discussion, decision-making and time management.

The process  

• The GP registrar observes a range of practice meetings and reflects on effective chairing behaviours.
• The GP registrar discusses chairing skills with a supervisor, either in a debrief or tutorial. A leadership style questionnaire may be used to support reflection.
• A role-play or simulated meeting may be used before chairing a real meeting.
• The supervisor identifies one or two suitable agenda items, or a suitable meeting, where the GP registrar can chair all or part of the discussion. Highly contentious or high-stakes items should be avoided.
• Following the meeting, the GP registrar receives timely formative feedback and reflects on the experience.

Intended outcomes

• Clarifying issues, areas of agreement and decisions required.
• Managing time and maintaining focus.
• Encouraging contribution from all participants and managing group dynamics.
• Understanding practice team roles and organisational decision-making.
• Managing disagreement or conflict constructively.
• Reviewing minutes and ensuring that decisions and actions reflect the discussion

Feedback may consider whether the chair set an agenda, clarified the purpose of the meeting, involved participants appropriately, managed interruptions, encouraged consensus, summarised progress and ensured clear actions.

Supporting the wellbeing of the practice team can contribute to sustainable, high-quality patient care. This activity involves developing or supporting a practical change intended to improve team wellbeing.

The process

• The GP registrar discusses potential wellbeing ideas with a range of team members.
• The GP registrar identifies an achievable intervention, such as a change to team routines or a shared activity.
• The GP registrar seeks support from key stakeholders before presenting the proposal to the wider team.
• The GP registrar works with colleagues to introduce or embed the change. A change model, such as Kotter’s 8-step Change Model, may be helpful.

Intended Outcomes

• Working collaboratively with the wider practice team.
• Presenting ideas and building support for change.
• Understanding how to negotiate and implement change in a workplace setting.
• Reflecting on the GP role in supporting colleague wellbeing.

Clinical protocols support structured, consistent care and clarify responsibilities across the team. GPs are often involved in developing, reviewing and implementing protocols.

The process

• The GP registrar agrees whether to review an existing protocol or propose a new one.
• For an existing protocol, the GP registrar considers how it is accessed and used, whether it is fit for purpose, whether it aligns with local, regional or national guidance, how feedback is gathered, and when it was last reviewed.
• For a new protocol, the GP registrar identifies an area of practice where a protocol may support safe and consistent care. This may relate to national standards, local priorities or areas of care delivered by different members of the team.
• Where relevant, the GP registrar considers referral thresholds, criteria for stepped changes in therapy, accessibility for team members and arrangements for future review.
• The GP registrar discusses findings or proposals with relevant team members and receives formative feedback from the Educational Supervisor and others as appropriate.

Intended outcomes  

• Critically reviewing a clinical process within the practice.
• Using evidence and guidance to support clinical governance.
• Engaging with colleagues and valuing multidisciplinary perspectives.
• Considering patient safety and systems that support safe care.

Practice leaflets help patients understand available services and how to access them. This activity involves reviewing whether the leaflet meets relevant requirements and communicates effectively with the practice population.

The process

• The GP registrar reviews the leaflet against relevant requirements, including information about services, access, patient rights and responsibilities, and criteria for services such as home visits.
• The GP registrar considers whether additional information would be helpful, such as appointment arrangements, telephone consultations, languages spoken by healthcare professionals, or staff availability and areas of interest.
• The GP registrar considers accessibility and communication needs across the practice population, including groups who may experience barriers to accessing information.
• The GP registrar may compare the leaflet with examples from other practices.
• The GP registrar presents findings and recommendations to the practice team. If appropriate, the GP registrar may help implement changes and consider evaluation, such as patient feedback.   

Intended outcomes  

• Developing observational and analytical skills.
• Understanding practice services and how they are communicated.
• Considering patients’ rights, responsibilities and information needs.
• Reviewing communication from an inclusion and accessibility perspective. 
• Planning, negotiating and evaluating change.

Practice websites and intranets support communication with patients and staff. This activity involves reviewing how a digital resource is used, whether it meets its intended purpose and whether improvements are needed.

The process  

• The GP registrar first develops an understanding of the purpose and audience of the website, intranet or shared digital resource.
• The GP registrar reviews the content, considering what is present, what is missing, what is out of date and whether information is accessible and user-friendly.
• The GP registrar discusses the resource with relevant stakeholders, such as practice staff, clinicians or patients where appropriate.
• The GP registrar identifies a small number of areas for improvement and presents recommendations to the practice team.

Intended outcomes  

• Using observational and analytical skills in the context of digital communication.
• Understanding how the practice communicates with patients and staff.
• Considering accessibility, inclusion and usability.
• Planning and negotiating improvements with colleagues.