How to bring out the best in NHS teams

About five years ago, we recognised that we faced several challenges as a GP practice. The symptoms played out every day but there were no easy diagnoses. A very subtle problem was our organisational health, and that had become our background normality.

Setting off on an intentional journey to improve and working through it has led to a change of atmosphere, care, culture and possibilities. In a national General Practice environment that is fairly bleak, we now have a team that is hopeful, thriving and improving.

So what are some of the things that we’ve learned about building joy, resilience and hope in healthcare? Here are just three (there are more!) lessons we learned along the way in trying to improve the way we work…

Values and purpose

Culture is the force that preserves old ways of working. This is what makes change so difficult. But once improved, culture is also the force that protects the new way of working. A positive team culture of creativity, generosity and resilience creates a sense that improvements can be suggested, and those suggestions will be heard and supported.

As a team you can work to identify your purpose and values. And once you know what they are, create the mechanisms to reinforce those values and purpose so they are lived out in reality. For example, in recruitment we can be clearer on the type of people qualities we want . During appraisal we can discuss with our staff which values they are expressing well or may be able to develop further. We can start saying ‘no’ to activity that is an obstacle to our purpose.

Reflect on areas where your values and purpose are not playing out. For example, if vulnerable housebound patients are a priority in theory, but only 20% have been seen face to face in a year, you may want to plan to improve this. This can help you focus and feel more in control of doing what matters, rather than being defined by external factors.

Great meetings

Team performance hinges on relationships, communication and great decisions. All these can be developed in good meetings. They can also be a source of team spirit, morale, connection, envisioning and feeling heard.

But not all meetings are great, they involve a complex web of interactions, information and power. They need to be practised and carefully planned. Rather than relying on routine, there are many different formats that might make a better and more productive use of time. Planned connections, full team meetings, themed meetings, off-site time. Few people in the NHS have time to spare, yet making meetings really meaningful is something we often take for granted.

Learn what makes a high performing team

We need to bring the best out of our staff. Those people with the most potential are also often the first to leave when we don’t enable them to thrive! We also need to attend to those who are not performing, recruit the right people and ensure the right people are in the right roles.

For us, this process required the principles from Patrick Lencioni’s ‘Five dysfunctions of a team.’ That means addressing ​​any absence of trust, fear of conflict, lack of commitment, avoiding team accountability or objectives. At first glance these might seem negative but this isn’t about individual blame, it’s about team function.

Often people get little feedback until something goes wrong. There is often a lack of personal or organisational reflection about how roles can be optimised. This can be demoralising and lead to stagnation. Good listening, feedback and responding is essential.

We’re really proud of how far we have come but we recognise there is still a lot to do. The context still feels immensely challenging most days. But we have improved staff morale and retention, improved our atmosphere and culture and developed dynamic creativity within our staff. This, in turn, has enabled better access to great care, reduced complaints and improved patient satisfaction.

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