)
With demand for GPs outstripping supply, GP retention must be a priority in tackling the current workforce crisis. The NHS has lost the equivalent of 2,187 full-time fully qualified GPs since 2015, 8 per cent of the current total of full-time fully qualified GPs. GPs in the UK are reporting the highest stress levels and lowest job satisfaction compared to their counterparts in nine other high-income countries. I recently attended a roundtable that explored solutions for GP retention, organised by the Royal College of General Practitioners.
During this session, I heard Dr Lucy Henshall speak about the Welcome Back to Work programme. She spoke about how the programme helps GPs return to work safely after a break from clinical practice. After the roundtable, I spoke with Lucy and her colleague Penny Flack to understand more about how the principles of Welcome Back to Work could help improve NHS workforce retention.
At Welcome Back to Work, they begin with a simple question: ‘How can we help?’. This starts with Lucy and Penny being a listening ear, and having open, compassionate and curious conversations to develop a deep insight of each individual’s narrative and circumstances. Through these conversations they find that they’re able to foster a sense of shared understanding, trust, inclusivity and, ultimately, belonging.
'Without support, the journey of attempting to return to work can feel isolating and impossible.'
At the heart of every conversation is a lack of rules and restrictions, with Lucy and Penny taking the ‘shoulds’ and ‘musts’ out of the conversation. They encourage and give permission to individuals to bring all aspects of themselves and their wider life to the conversation.
Support for returning to work is then tailored to be person-centred by developing a holistic understanding of the individual’s specific needs through these open conversations. Lucy and Penny work in partnership with individuals to support them and provide practical guidance to help navigate the road back to work together using their experience, wisdom and understanding of the NHS. This can involve guiding clinicians to opportunities to refresh their skills, in turn helping them feel supported to practice again.
During the process, they acknowledge the wealth of knowledge and experience that colleagues have and focus on utilising their strengths. Lucy and Penny stressed the importance of not making assumptions about people or what the return to work might look like, and instead think about how the process can be enabling, with reasonable adjustments made in the workplace where required. Without support, the journey of attempting to return to work can feel isolating and impossible. Welcome Back to Work fosters this ongoing supportive environment through an alumni group, which helps build relationships and allows for peer networking among those with shared experiences.
I can see that retention needs to be a priority to break the vicious cycle of staff leaving and unsustainable workloads.
Practically, there could be benefits of adopting the principles of tailored, compassionate, holistic support more widely, including geographically over a larger area and more broadly to the whole health and social care workforce in any conversations about staff facing issues that are leading them to think about leaving. I am currently training to be a GP and when looking towards the future, I can see that retention needs to be a priority to break the vicious cycle of staff leaving and unsustainable workloads.
The NHS Long Term Workforce Plan sets out the path to increase the number of GP training places by 50 per cent, but there is little point in training more GPs if we are unable to retain these individuals. I have seen within general practice first hand during my training how holistic, flexible approaches can help to retain staff, such as adjusting working hours based on caring commitments or agreeing a particular day of the week to work from home. More compassionate and wiser workplaces that understand individuals’ needs and wishes may help to retain NHS staff, and I hope in my future career if I or anyone else needs support at work or to return to work, this would be approached with kindness, flexibility and be person-centred.
The fundamental principles of Welcome Back to Work are effective but simple: to listen to, value and support individuals. Those in management and leadership roles could reflect on these behaviours and values and think about promoting these within their own organisations. There are many wide-ranging complex issues affecting workforce retention, but compassionate curiosity is an essential component that may help support staff to remain in and return to the profession.