If I ran my local GP practice...

If I spent some time in my local NHS GP practice, I am positive I could find areas where people, process and technology are clashing rather than working in unison to provide a good patient experience.

I do not know exactly how their operations are set up, but I can make some educated observations on what the issues are because I am both an NHS patient and I use the services of my local GP and I have years of experience of running and improving service operations in the private sector.


It does for the most part seem as though the people I have dealt with, reception staff, practice nurses, GPs and so on, genuinely want to do a good job but frequently use language which seeks to pass blame elsewhere for the failings of the practice.

I have never been in a role in which it has been acceptable for me to blame anyone or anything else for the failings of my department. I have never worked in an environment where more money was the answer. I have therefore always encouraged my people to take responsibility for their actions and to create a ‘can do’ culture. Perhaps this approach could be replicated?


I strongly believe that having processes in place is always better than not; they provide control, consistency, ability to measure performance and so on, but they work better in a culture where people feel empowered to make continuous improvements. I recall an all-hands meeting with my department during which I ‘gave them permission’ to fix any broken processes, provided it could be done at no or minimal cost, would improve their day-to-day job and provide better customer service. Linked to processes are measures and it is vital that the right things are measured in the right way. Again, I recall a conversation where I told my boss I could deliver 100% calls answered in less than 10 seconds every day without fail. Sounds impressive, but easily achievable by instructing call centre agents to answer the phone and say “Hello. Goodbye.”, hang up and take the next call. The point was of course that I could deliver on one measure, but customer service would be terrible. If your people are in the right head-space, good process will follow.


When I call my GP practice, there is no call queuing system; I have to call many, many times and get hung up on many, many times before speaking to a receptionist who advises less than 15 minutes after the surgery opened that there are no appointments left for the day. I am told that a particular booking system is being accessed but it’s very slow so could I hold on.

Indications are that the technology is either not fit for purpose, has been poorly implemented or that people have not been trained how to use it. I also suspect that the technology has been engineered to deliver reporting to the Care Commissioning Group, which seems to be at odds with the overall experience felt by patients.

To conclude, I believe that much could be done to improve service from my GP practice at no cost. Investing time in creating a positive, ‘can do’ people culture can give an uplift in productivity and service of around 35%; focusing on process improvement will deliver a further 35% improvement and investment in technology can deliver the remainder.

I suspect that the biggest challenge is in breaking the train of thought which believes that the only way to improve the NHS is to spend more money on it.

If you'd like to discuss this article, drop me an email at phil@pragmatiksconsulting.co.uk, call me on +44 115 888 1200 or schedule a Zoom at https://www.pragmatiksconsulting.co.uk/book-online.