By James Shields - 24th May 2022
Read time - 8 minutes

Are you looking to increase general practice capacity in your community?

Staffing issues have been affecting health and social care in the UK for decades. On top of that, in the past 24 months, the pandemic pushed staff and staffing challenges to a new maximum with increased demand, absenteeism and unprecedented pressure. It affected all parts of the NHS in different ways both exacerbating old issues and presenting new challenges.

General practice is no different. It experienced a double whammy of surging demand combined with a range of new service initiatives from NHS England - all of which need staff to support. Not only did GPs deliver 75% of Covid-19 vaccinations but all the while going through a major restructuring and with new services like teleconsultations, ARRS staff, community care and Extended Access being pushed through.

This was combined with new key funding changes, stretched managers and a difficult recruitment market. Not surprisingly this has led to capacity issues across general practice. It has left Practices, PCNs, Feds and the whole Primary Care community understaffed, with vacancies putting pressure on staff, disrupting services and restricting service development.

City & Hackney GP Confederation

This is the challenge City and Hackney faced and which was identified by the City & Hackney GP Confederation (Confed). The Confed which supports general practice in two boroughs of northeast London was in communication with their 40 Practices and 5 PCNs where they realised the scale of extra staff that was needed across the community.

Extra capacity needed in general practice

Having run a very successful Covid-19 vaccination programme, which they had handed over to their PCNs and that was already scaling down, they realised that they had potential spare capacity in the system from staff who had worked the vaccination clinics for the past year. At one stage the vaccination programme had over 40 staff (from receptionists to nurses and paramedics) working per day so the challenge was redirecting that huge pool of local, engaged, qualified and known staff into the Practices and PCNs.

In an initial attempt to do this, the Confed was running a Staff Register which was a manual list of staff and their availability, distributed weekly. It worked to an extent but was difficult for staff, not maintained in real-time, provided no data to manage it and added to Managers’ workload to use.

They needed a way to scale the staff register, increase the number of staff working on it and make it more accessible to Practices, PCNs and their managers across the two boroughs.

Working with Circular Wave

Circular Wave specialise in supporting collaborative workforce management and developing new ways of working. We have been working with City & Hackney GP Confederation since March 2021 and supporting staff management for the Covid vaccination programme which had since been handed over to the PCNs. After that we had supported Community Nursing and were working the PCNs directly too. The Confed had helped design mnay of the services on the Circular Wave platform and we'd built a great working relationship.

Building a flexible staff bank that scales

Working together we quickly realised that the fastest way to scale the Staff Register and support the 40 Practices with additional flexible working staff was to integrate the service with the Covid-19 vaccination programme.

Using the Circular Wave platform, the Confed would be able to streamline each step of the process (compliance, shift matching, timesheets, payroll and communication) through a single mobile app for staff and a web app for Practices/PCNs. The beauty being that most staff and managers within City & Hackney were already using the Circular Wave app for the vaccination service.

These staff and managers were already comfortable and familiar with the app and fans of the digital management system. We just needed to integrate the two services so that all the staff who have been working at the vaccination service could be connected with Practices and pick up their shifts.

Develop, deploy and engage

It took 4 weeks to develop the functionality to integrate the flexible staff bank with the Covid-19 vacination programme, adding a new compliance requirement (an automated DBS checker) and developing the access portal for each of the 40 Practices and 5 PCNs. We put together a communication and engagement plan to support the Practice Managers and staff.

For Practices Managers, who were most critical for the success of the service, we first hosted a webinar. This was a 15 min presentation followed by a Q&A held remotely during Thursday lunch. This showed the Practice Managers how to access the staff bank and allowed them to ask questions about the change in the process. The webinar was also recorded and shared online.

These are busy people and so we backed this up with regular email reminders for managers who had not completed their sign up process or uploaded their first shift. We sent a regular newsletter outlining the number of staff working each week and profiling staff.

We also hosted 1-on-1 training sessions with Managers who required extra assistance or were hesitant. This was done remotely and in less than 15 minutes, Practice Managers were given all the support they needed to connect with staff and fill vacant shifts.

Live across City and Hackney

The flexible staff bank is now live. It has over 100 staff avialble for adminstrative and clinical shifts. All 40 Practices and 5 PCNs have access, can release shifts in seconds and fill vacancies with local and vetted staff.

For staff, many of whom have been regulars in the vaccination programme, the GP shifts have compensated for the reduced vaccination shifts. It means they can continue to work in the area where they live and are familiar.

As for the Confederation, its aim was to increase the capacity of all the Practices by utilising this pool of staff and to keep them working in the local community. This will be demonstrated by the longterm use of the service and this is certainly a promising start.

For all enquiries contact [email protected] or give us a call on 0333 987 4045.

James Shields

CEO - Circular Wave