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Fixes for 5 common pain points in Primary Care / PCNs in 2022

In this article, we will offer solutions for some of the pain points we are seeing regularly in practices / PCNs we are supporting. All of these solutions are built out of psychological expertise and seen to work in reality, so more than just a thought exercise.

I often write in a ‘take what you need’ style, so take what you need from the ideas below in relation to the pain points that feel most salient for you right now.

1. Difficult relationships between partners.

This is our most regular commissioning reason at present, and it is understandable. The complex context of primary care — PCN formations, innovation at pace, high demand, exhausted staff is not a good recipe for great functioning leadership. Especially in a place where these leaders are clinicians, leading businesses that are far more complex in design than most businesses led by trained business specialists!

We have provided 7 tools for working on partner (and manager) relationships in our article by the same name, here. Including the creation of team building spaces, checking in with each other, learning to notice the value of each other, communication needs and more

2. Unhappy practice / PCN manager (feeling undervalued).

I can count on one hand how many teams, out of 100s, we have worked with — where the practice manager did not feel undervalued or misused. Practice managers are one of the most valuable assets in Primary Care, and increasingly so. With the increased complexity of the role, the replacement of a practice manager is a daunting task and comes with significant periods of chaos and disruption for primary care.

Although I firmly believe that primary care partners need to communicate value to managers (stated above), I do also recognise that practice managers can benefit from understanding their role and why value can be difficult to feel. Here is a piece for managers that has been one of our most popular, since we wrote it.

(we wrote a chapter about feeling value as a GP, in our book — which you can get for free, see below).

3. Staff retention issues.

Staff retention is a threat in Primary Care, as the needs of practices are so high against the resources they have. The loss of a valued staff member is painful. This means that a strategy for keeping staff (and engaging them) is worth the time spent on it.

We have summarised this into this article that details 8 considerations for your PCN / practice to build a culture of retention, recognising that the role can feel less than ideal for those in it.

4. Unhappy patients (difficult conversations).

Primary Care admin staff are walking out of the NHS in droves, that being a headline title in a recent newspaper article. It reflects what we hear on the ground.

For many staff, they name the difficult conversations that are had with patients as the main reason.

We’ve met this need with an article detailing what staff might need (including and beyond skills training) and a digital training programme that delivers on all of these needs (here, with a free sample). The programme is already commissioned at the regional level in the UK, with numerous regions discussing commissioning. Check out if your region has bought it, or if it is worth the cost for your team — we made it VERY affordable!

5. Exhausted leaders leading exhausted staff.

I feel sorry for leaders who are told to ‘be compassionate’ when they lack the energy to be compassionate to themselves.

Here are 2 articles that might help… how to energise an exhausted team and how to be compassionate to yourself as a leader. They go hand in hand, so don’t forget to read the one aimed at you. Many PC leaders are so used to putting themselves last, they forget the value of being well in the role, to be a great leader!


I hope this helps, it represents work we see work and my own passion to see Primary Care staff thrive.

Find more ideas in our book (Leading Primary Care: Resilience, Team Culture & Innovation) which is available on amazon or for free in digital version here. 26 ideas that go beyond the PCN to think about GPs, managers and the wider team.

If you need help, you can also contact us directly.



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