Flexible work aspects you must master

Flexible work aspects you must master

There are key areas to consider when implementing a flexible working policy.


There is absolutely no doubt that communication is harder when teams are working flexibly, and considerable effort should be put into providing easy and effective ways for individuals and teams to communicate. 

To a certain extent, this requires a culture shift and new rules of engagement to avoid everyone relying totally on email for communication. 

Everyone needs to be encouraged to pick up the phone and speak to others, ideally using video calls so people see one another regularly. 

This does not happen naturally, as people are worried about interrupting others and shy about using video. Encourage people to book a time to talk by phone or ideally video and ensure this behaviour is led by the leaders of the organisation. 

The hardest communication to encourage in a virtual working environment is friendly chats. How was your weekend? How is your son getting on at university?
. . . and so on.

It is important to allow for these types of conversations to foster team spirit and develop healthy working relationships across teams. 

At Designated Medical we have a weekly ‘cuppa and a chat’ that is completely optional but open for those who want to drop in for a bit of light relief. 

Every quarter we hold a ‘town hall’ meeting which is a more formal event, bringing the whole company together for a business update followed by a fun activity led by someone on the team. 



Technology enables flexible working and is a vital consideration. 

Working flexibly requires a truly paperless office environment, and those who are still relying on processes that depend on paper changing hands will need to revise these processes and most often employ technology as the enabler. 

This might involve the use of SharePoint for Microsoft Users or Google Drive or increased use of specialist cloud-based systems such as practice management systems and other relevant ones that encompass your marketing, finance, and human resources departments. 

For example, Xero is a commonly used accounting system that enables remote working for your finance team. Cost-effective technology is widely available and, implemented correctly, can provide huge efficiencies. 

Video calls, either using Zoom or Microsoft Teams, are now familiar and we have all now learned where the unmute button is! There are numerous other technologies to encourage communication and collaboration, including Slack, conference calls, shared documents. 


One of the biggest problems with the Covid experience of home working is that everyone was forced to do it rather than choosing to do it. 

A flexible working policy will generally be a big positive when you are recruiting and it also allows you to recruit from wider geography. 

Instead of being limited by commuting time to the office or clinic, you can potentially recruit from further afield and appeal to a broader group of candidates. 

We currently have marketing managers working for us based in South Africa and Spain. We also have a book-keeper based in New Zealand. The time difference is a consideration, of course, but aside from that, most things are possible.

However, flexible working and especially home working does not suit everyone. The ONS Survey that I mentioned previously reported that younger people are less likely to work from home and this is for good reason. 

For those who are starting in their career, the benefit of an office environment is significant, as it provides the opportunity to learn from senior team members and managers. Working in collaboration is very important in the early stages of any job. 

There is also a sociable element to consider, with younger people and new joiners more likely to feel isolated working from home and valuing the opportunity to make contacts and even friends at work over a coffee or popping out for a glass of wine after work on a Thursday evening.

Anybody who saw the struggles of the news presenter last summer, being interrupted by a small child mid-broadcast, will also recognise that home working is not always well suited to those who have young children unless they have an office space to protect them from unexpected interruptions and childcare in the home.  


There are numerous examples of excellent training provided via online learning remotely and flexibly, including the Open Univ-ersity which has been doing so since 1969. Even softer skills like leadership and management can be learned in a remote working environment. 

I have absolutely no doubt that it is possible and often sensible to manage training in this way. The ability for consultants to learn new techniques by watching a video of another consultant performing it, perhaps in another country, is hugely powerful. 

But, as I said earlier, we cannot underestimate the power of individuals learning from colleagues in person, especially more senior individuals within an organisation; and I would offer a slight health warning regarding the more informal training concerning graduates, younger team members and new recruits to an organisation.  


Managing a remote team requires a greater focus on communication when team members are working on an individual basis and there needs to be built-in plans to bring the team members together to have discussions that ensure they continue to work together as one team. 

The responsibility for creating this culture will always lie with the manager leader and, ideally, we need a team manager who embraces flexible working and leads by example, using video and conference calls to encourage team discussion and collaboration. 

It is at this point I will raise the thorny question that I am often asked by managers who are sceptical about flexible working, which is ‘How do I know if my employees are working at home?’

This is a good question and I could spend considerable time answering this, so I will try to summarise by saying that trust is vital. Most people come to work to do a good job and take pride in their role. 

The minority of people, who are not committed to their work and are lazy in the office, will also be lazy when working from home and this is a management issue regardless of the working environment. 

Most people value the opportunity to work in the most productive way for them and will deliver a greater contribution to your organisation when trusted to do a good job.

Its outcomes that count 

As leaders, we need to think about the work our teams are doing differently. Ultimately, it is the outcomes of the work that is done that is most important. 

If a medical PA is running a busy practice, answering patients’ phone calls, booking appointments, typing dictations in a timely way and the consultant and patients are happy, we know that person is doing a good job. 

We could check the medical PA is logged on to the practice management system at 9am sharp but if the outcomes of the work being done are all good, then this is unnecessary and potentially damaging to the culture of the team. 

This type of checking and micro-management should only be needed when we have doubts about the outcomes.  

In many companies, there is a culture of presenteeism. Those employees at their office desk at 8am and still there at 7pm are the ones in line for a promotion. But with flexible working, we need a culture where our employees are trusted to do their job. 

We must measure their performance on the quality of the work they deliver. At the end of the day, this is what benefits our patients and ultimately benefits our organisations. 


In conclusion, I would like to re-emphasise my opinion that a flexible working policy is essential for all organisations, but it requires real thought as to which roles are suited to a flexible approach, consideration given to the people who would embrace flexible working and the implementation of technologies and a working culture that supports it. 

And, as business leaders, we need to pay attention to the development of the next generation of employees joining our teams, who need the support and guidance of more experienced team members and managers.

If you would like to discuss your flexible working policy with me, please do get in touch and I will be happy to share any advice and guidance from my own personal experiences.



How to be a flexible working winner!

How to be a flexible working winner!

Our Managing Director Jane Braithwaite explores the topic of flexible working and how we can use it to our benefit within the healthcare sector, focusing on what it means for employers and employees.

She covers how to manage a remote team, the technology that enables efficient remote working, and how to ensure you reap the benefits of a flexible working policy.

Caring for and treating sick patients requires face-to-face contact and, clearly, our healthcare organisations must be built around this capability. But 2020 taught us there are many aspects of healthcare that can be managed without the need for us to be together in the same location. 

We have learned these lessons in a crisis-type situation having to adapt incredibly quickly, with no clarity on the time-scales involved and huge uncertainty as to what the next challenge might be. 

The principles of flexible working have been accepted by organisations for some time, but the Covid-19 crisis has accelerated its adoption hugely and it has been an absolute necessity in many situations. 

Adoption of these new working practices has been sudden and dramatic and a terrible upheaval for many, who have found their working and professional circumstances altered drastically. 

But we have learned that flexible working, in the right environment, managed in the right way, can offer benefits.


Great benefits

Benefits such as greater efficiencies and productivity, the ability to provide a service across increased geography, the potential to reduce costs, and, possibly most importantly, it really benefits many people, allowing them to do their job more productively and improves their well-being. 

We have also seen how embracing flexible working has impacted communications with patients, with the wider use of phone triage and video consultations. 

While these solutions clearly cannot replace the need for treatment provided in person in a hospital environment, they clearly can add some value in terms of patient care and potentially productivity for healthcare providers. 

Many of you will have concerns about how to ensure people work well together, particularly in terms of the ability to collaborate and how to recruit new team members and ensure they feel part of the existing team. 

This is a topic very dear to my heart, as everyone in my company has been based at home, working flexibly since I started the business back in 2013. 

I am a big fan of flexible working, but I will talk openly and honestly about the pros and cons and how to avoid some of the pitfalls and I will also address the question I am asked most by those who are skeptical about home working, which is ‘How do I know my team is working when they are at home?’


What is flexible working?

The term flexible working is self-explanatory on initial consideration, but it does cover a whole range of options, so it is worth breaking it down and considering all the possibilities. 

Flexible working encompasses flexible hours and/or flexible locations. So, it also covers part-time working with flexible working hours, and remote working, which can mean home working or it could also mean working from
several different locations.

Many of the consultants we support at Designated Medical work flexibly, managing clinics at a few different hospitals and clinic locations. It is also fair to say they work flexibly in terms of hours, as they rarely keep to the standard nine-to-five schedule, holding evening and weekend clinics. 

Over the last few months, many of our consultants have also been offering video consultations for their patients, which can be done anywhere including at home.

Loss of office space 

Many doctors work from one permanent consulting room with a permanent team of staff also based in an adjoining office. But this model is becoming less common over time, largely due to the cost of consulting and office space especially in central London and other urban locations. 

Homeworking is also used by most people to some degree. The ability to ‘log on’ from a home computer, laptop, tablet or phone makes home working very accessible.  

Technology is most definitely a key factor in flexible working and we will discuss this in more detail later. 

When you consider home working and working from different locations, it is fair to say that most people are working flexibly to some degree these days and our response to Covid-19 has driven far greater take-up of these options.

At the end of March 2020, the Office for National Statistics launched the online Labour Market Survey. The survey takes place each quarter, involves approximately 18,000 households, and asks questions regarding employment in general, but also includes specific questions regarding home working which are relevant to our topic. 

Survey results

These are the main points from the survey:

  • In April 2020, 46.6% of people in employment did some work at home;
  • Of those who did some work from home, 86.0% did so because of the Covid-19 pandemic;
  • Of those who did some work from home, around one-third worked fewer hours than usual (34.4%), and around one-third worked more hours than usual (30.3%);
  • Women were slightly more likely to do some work at home than men, 47.5% and 45.7% respectively;
  • People aged 16 to 24 years were less likely to do some work from home than those in older age groups;
  • More than half of people living in London (57.2%) did some work at home;
  • Occupations requiring higher qualifications and more experience were more likely to provide home working opportunities than elementary and manual occupations.

Clearly, the results from the survey are hugely affected by Covid-19 and it will be interesting to see results going forward, but there are some points made here that we should consider – in particular, the point that younger people are less likely to work from home. 

What do employees want?

There are countless surveys, reports, and press articles attempting to answer this question and the claims are often contradictory. 

Some say how home working is the answer to work-life balance and the solution we have all been searching for, stating vast imp­rove­ments in productivity and employee well-being. 

Others focus on the lack of company culture that results in feelings of isolation and a decline in productivity. 

Any regular LinkedIn users will have seen ad hoc surveys over the last few months and the results seem to imply that people want a mix of both home and office working, but a strong negative reaction to being totally office-based. A blended approach with flexibility seems to be the preference for most. 

Chatting with friends and family, we find this is a Marmite topic – you either love it or you hate it. Many of us absolutely love the flexibility, the ability to focus and concentrate, and to take control of our schedules. 

Others hate the constant demand to attend Zoom meetings and miss the spontaneous discussions over a coffee and the creativity of working together in an office. 

And for many households, home working created a pressure cooker with two adults trying to find space in the home to work, often sharing an inadequate broadband signal, and many facing the prospect of home-schooling.

Over the summer months, the Government published guidance on ‘Making your workplace Covid secure during the coronavirus pandemic’ and employers have been challenged with Covid risk assessments to ensure a safe environment for their employees.

Fear of office

In a recent poll of UK employers by Peninsula, one-in-seven employers admitted that they were not confident their workplace was COVID-secure. And a further one in four said they were only ‘fairly confident’, which is incredibly worrying given that there is a risk of fines for employers who do not provide a Covid-safe working environment 

I have already admitted to being a huge advocate of flexible working and, personally, I believe that all employers should have a flexible working policy. But I also believe that there is a requirement for a very well thought-through policy. 

The introduction of home working because of Covid was immediate and dramatic. This is not an ideal way to introduce huge change to how an organisation works and it is no surprise that many people, both employers, and employees, have found the situation less than ideal. 

There was no time to plan, to introduce supportive technology to enable home working or to change how teams communicate and collaborate to ensure that flexible working was successful. There was no time to create a policy.

But, to move forward successfully, it is important to take the time to create a well-considered policy that enables businesses and organisations to reap the benefits of flexible working and enables employees to succeed and prosper. 

Before creating your flexible working policy, it is important to be clear on the benefits for both your organisation and the employees the policy will affect. 

Benefits to employers

The number-one benefit to employers will be happier employees. 

Most people do want more flexibility, and offering a flexible working policy will be positive for your current team and will also appeal to potential candidates when you are recruiting.

The other main benefit is potential cost savings, particularly in office accommodation. 

By implementing a flexible working policy, you may be able to reduce the amount of office space needed overall. 

Some roles are suited to home working for 100% of the time and implementing such a policy could reduce the need for office space considerably. 

For roles where a blended approach of home working and office working is best suited, savings in space may also be made by implementing a hot-desking policy. 

And for hospitals and clinics with offices dedicated to admin support, there is an opportunity to reclaim that space and turn it into consulting space and therefore make it profit-generating. 

Administrative support is suited to remote working and an important area that everyone should consider. 

The systems are in place to allow most administrative jobs to be managed remotely and, for many people working in these roles, remote working is preferred. 

The cost savings in office space could be considerable and the improvement in employee morale could be great.

For growing clinics where space is at a premium, a flexible working policy may allow you to continue to grow without increasing your accommodation costs by reassessing how space is currently used, moving some employees to a flexible working policy, and reallocating office space. 

Benefits to employees

Most employees value a flexible working policy, as it helps them gain a better work-life balance; many workers save a couple of hours each day previously spent commuting, not to mention the cost of their season ticket. 

For others, the ability to choose to work some days in the office and other days from home is appealing. The ability to work from home to focus, without disruptions, on a particular activity, project or research activity is hugely beneficial. 

These are the key benefits, but many others may be relevant to your organisation and your employees. For example, for those of us who are concerned about the environment and climate change, the impact of less commuting is considerable.

Benefits to patients

Lockdown situations mean many patients are offered medical care via phone and video consultations and obviously the GP, consultant, or healthcare professional could be making these calls from any location, including their own home. 

At the time, this was often the only care that patients could be offered, but we also saw the positive effects of offering certain levels of care in this manner. 

These consultations will never replace the need for treating people in person, but they can be part of the overall approach to patient care. 

For many patients, the reassurance of discussing their concerns with their doctor without the need to travel while feeling unwell is a huge plus. 

Another example is when a patient is preparing to come into the hospital for surgery; they are often anxious, needing reassurance and building up a list of questions they want to ask. 

Offering these patients, a short phone or video consultation before attending the hospital would be welcomed by many patients and it is an approach we are suggesting to many of our consultants. 

We know that most patients call within 24 hours of having surgery and so a proactive approach will avoid last-minute panics. 

We could consider a flexible working policy allowing GP’s and consultants to work flexibly from home, providing phone and video consultations as a form of triage before face-to-face appointments being booked, allowing us to have greater control of how urgent appointments are allocated.  

For GP practices where space is at a premium, this could be a good solution, and offering flexible working contracts may help to alleviate the problems of recruitment. 

See IPT article ‘Flexible work aspects you must master

Brexit and private healthcare

Brexit and private healthcare

The start of 2021 has understandably been dominated by the continued coverage of the COVID-19 pandemic, but the 1st of January 2021 also marked the date the UK left the EU, and this brings changes for all of us in the UK both in our personal and business lives.

On Christmas Eve, Boris Johnson proudly announced that a UK-EU trade deal had been agreed, containing rules for living, working and trading together and this agreement took effect from 11pm on 31st December.

At Designated Medical, our goal is to help our consultants manage and grow their private practices, providing the support needed to enable them to succeed whilst also reducing the stress and pressure of working in private practice. As part of this commitment, we regularly share our expertise and knowledge, aiming to offer helpful guidance on best practice.

We have been reviewing how Brexit affects our business and we thought it would be helpful to share our understanding with our consultants too, in the hope that it may help you understand the key changes. We are by no means experts on this subject and the information we provide is gleaned from our research using the information provided by the Government on their website.

We would welcome your feedback and comments to help us all gain a deeper understanding of the important changes.

The UK-EU trade deal is a 1200-page document, (the summary is 34 pages long) describing exactly what has been agreed which I doubt many of us will find the time or motivation to read, but we do need to assess how Brexit affects the private healthcare sector. The full document can be accessed here.

Brexit seems to affect the private healthcare sector in three main ways as follows:-

  • Importing/exporting medical supplies and devices
  • Sharing data
  • Recruitment

Importing and exporting medical supplies and devices

As we were made very aware in the run-up to Christmas, the borders between the UK and the EU are vital to the flow of goods and any changes risk problems developing quickly.

When France shut their borders on Sunday 20th December, a queue of over 2000 lorries very quickly formed and there is a lot of anxiety that this could happen in the coming weeks and months as a result of the new rules regarding the import and export of goods.

In the private healthcare sector, we rely on importing drugs, vaccines, medical equipment, and medical supplies and so this is an area we need to think about carefully.

Obviously, the news of the Oxford vaccine is phenomenal, and it is wonderful that we have been able to create this vaccine in the UK so quickly, but many of our medicines and medical supplies are imported into the UK and the Brexit deal changes the way this is managed. Most of us will not be directly involved, but we will be reliant on our suppliers to ensure that supplies are able to reach us in a timely manner. Suppliers will be responsible for handling the change of process and the additional administration involved, but we also have a responsibility to make sure we have access to the supplies needed to deliver care to our patients.

EU citizens currently living in the UK by 31st December 2020 will see no change to their rights and status until 30 June 2021. To continue living in the UK after June, EU citizens can apply to the UK settlement scheme. For EU citizens moving to the UK after 1st January 2021, they may be required to apply for a Visa.

Employers will be able to recruit “Skilled workers” from the EU after 1st January, but it will not be possible to recruit from outside the UK for jobs offering a salary below £20,480 or jobs at a skill level below “RQF3” which we understand is equivalent to A level. For some jobs in health and education and also for people at the start of their careers, there are different salary rules.

To understand more about the required skill level and salary levels read more here.

There is a documented process to follow to employ a skilled worker and you will also need to pay a licence fee between £536 and £1,476 depending on whether you are classified as a small sponsor or charity, or a medium or large sponsor.

In summary, as business owners, doctors and employers, we need to consider how Brexit affects us and ensure we are aware of the additional responsibilities it places upon us.

As mentioned earlier, this is not our area of expertise and we are approaching this as a business, ensuring our own company is compliant, and also as a service provider to consultants working in private healthcare.

We want to make sure we are well informed, and we thought it would be helpful to others for us to summarise and share our understanding along with references to key supporting information.

As always, we welcome your feedback and comments, especially if you have a deeper understanding than we do. If we receive a significant amount of information from readers that we think will be valuable to others, we will review and update this article and re-post.

We look forward to hearing from you.

Harness People Power

Harness People Power

Our managing director Jane Braithwaite explores the broad subject of managing people and teams, covering topics such as our responsibility as employers, leadership styles, different employment models and well-being.

In this issue, she recommends the three ‘C’s – clarity, communication and care – for improving the power of your people and managing your team through this difficult period.

It is the people within them that make companies and businesses work, and this is especially true in healthcare. Despite huge advances in technology, including the automation of many administrative processes such as the incorporation of robotic surgery and the use of artificial intelligence in diagnosis, it is still fundamental in all healthcare businesses to have the right people, with the right skills and attitude in the right roles. There are very few examples of services or businesses where one person can do everything and, in most cases, it takes a team effort.

Sense of achievement

If you are a surgeon, for example, there may be moments where you feel you are alone, but caring for your patients is a communal effort and requires the commitment and dedication of a group of people with varied skillsets working together. 

A well-performing team is a joy and being part of such a team is fulfilling on many levels: the sense of achievement and belonging, the feeling of being respected and of making a valued personal contribution. But for every high-performing team, there is an opposite, less successful example. Most of us have experienced at least one team in our career that is verging on dysfunctional. 

Prior to the Covid-19 pandemic, we were already aware that, in the UK, people were feeling under pressure and struggling to maintain a healthy work-life balance. Of greatest concern in this current climate is the increased pressure that people are experiencing in both their personal and professional lives. Everyone is attempting to handle the uncertainty of Covid, coping with the lack of control, worries about their health,  finances and the health of their friends, families and colleagues. 

Relying on adrenaline

In a crisis, we rely on adrenaline to help us perform and, in most cases, the crisis is short-lived and this short-term solution is appropriate. To continue to rely on adrenaline on a long-term basis is potentially damaging and we expect this to cause numerous longer-term issues. 

In the early days and weeks of the pandemic, business owners, including those in private healthcare, focused on survival. What do we need to do to get through this? At the time, there was a sense that this would last for weeks rather than months. 

The Government announced measures to support employers in the form of the job retention scheme alongside various loans and grants, to support us in achieving the goal of survival. Many individuals were furloughed from their positions and some continue to be furloughed at the time of writing due to a further extension of the policy.  While being furloughed may sound like a pretty good deal, many have suffered from increased stress due to job insecurity and anxieties related to financial and career impacts. In the worst-case scenarios, we have seen an increasing number of people being made redundant and there is an expectation this will continue as the Government schemes eventually come to an end. 

For those individuals who have worked throughout the pandemic, we are seeing signs of burn-out. 

Tension between colleagues

However, one unanticipated symptom of furlough is a tension between work colleagues where those who have continued to work perceive their furloughed colleagues to have had the easy option, leading to an underlying resentment. Many of us have been adapting to working from home either on a part-time or full-time basis and this brings about a new set of challenges. Initially, it was the logistical issues of home-working that focused our attention. Setting up secure IT systems, adapting to working in a paperless manner, talking to one another via Zoom and so on.  As the weeks and months have passed, our focus has shifted to the reality of working remotely long-term, managing teams of remote workers and ensuring everyone remains motivated and productive. 

Bringing staff back

Clinics and offices have faced the challenge of bringing their employees back in a Covid-safe manner and adapting the physical environment to ensure it is safe and compliant. Space limitations have reduced the number of people who can physically be in the workplace on any particular day, leaving members of staff continuing to work at home on a part- or full-time basis. Some people have been reluctant to return to the office, either because they love working from home or they are scared to come back, particularly if their commute involves public transport. The current crisis looks set to continue for some time and, as leaders and managers in healthcare, we need to take action to address these issues and support the people that make up our teams so that they continue to be high performing. With that in mind, how do we create high-performing teams in this current climate? It is a challenge!

This month, my initial recommendations for improving the power of your people and managing your team through this difficult period are clarity, commun­ication and care.


Clarity helps to alleviate a lack of control and improving clarity may help many people to deal with the current environment.  Many of us may feel that we need to regroup and rebuild, and we are faced with the challenge of doing this in difficult circumstances, as the immediate future is not totally clear to us. In times of uncertainty like this, it is often valuable to go back to basics and consider the way in which we manage people, to review our responsibilities as employers and improve our policies and processes from a people perspective. 

We adapted our workplaces very quickly to allow our organisations to continue to operate and survive the crisis. Our teams accepted this and changed quickly too, but, in our haste, we may have lost some clarity regarding roles and responsibilities. We need to reconnect with our teams to understand how the changes have affected them, how they are feeling about these changes, what is working well now and what needs addressing. Ensuring that everybody has clarity on their individual responsibilities and how their role impacts on others within the team will enhance both individual and team performance. A positive way to do this is to review each team member’s objectives so they have absolute clarity of what is expected of them in the short term, the next month and quarter. 


Good leaders communicate with their teams, both individually and together, on a regular basis. If in doubt, over-communicate. In a time of crisis, we all need reassurance, and communication is vital to provide this reassurance. Ensuring everyone is aware of the current situation and what changes are happening is important, even at times when we are not entirely sure ourselves. Many people are interacting less with work colleagues as well as in their personal lives and this can lead to feelings of isolation. 

If your team is working remotely, communication is even more important. You can communicate in a variety of ways including emails, video and phone calls.  Not all communication needs to be formal and you may want to recreate the office atmosphere by agreeing a regular, perhaps weekly, opportunity for a general chit chat over a cup of tea. 


Caring for our teams and providing additional support will pay dividends in the short and long term. The topic of mental health is being discussed more openly than ever and appropriately so, given the number of individuals in the UK who are suffering from some form of mental health problem. Again, we were aware that this was a big issue prior to Covid, but this has exacerbated the situation in a big way. Absence from work due to mental health has increased over the last few years, which has led to mental health becoming a boardroom discussion, as it impacts on the productivity of an organisation. As employers, we have a ‘duty of care’ and a responsibility to do all we reasonably can to support our employees’ health, safety and well-being. 

If a member of our team has a mental health issue, we need to talk to them to determine what support they might need. If an employee feels they are well supported, the issue is less likely to build up, which results in less time off, improved morale and greater loyalty. 

Creating a culture where mental health can be talked about as openly as physical health will allow individuals to raise their concerns and worries before they become significant. 

Employee survey

You could consider running an employee survey, asking specific questions relating to well-being and mental health and collecting responses in an anonymous way to give you a true picture of how your team are feeling. Having one-to-one discussions with each employee allows an opportunity for personal issues to be raised and discussed in a safe environment. Consider creating a mental health or well-being champion for your organisation or making mental health training available. Leaders who address well-being and mental health will allow their team to succeed and will also benefit from greater loyalty on a long-term basis. 

Look to patients too scared of Covid to seek help

Look to patients too scared of Covid to seek help

Article written by Robin Stride and originally published on Independent Practitioner Today, 8th December 2020

Private doctors are being advised today to rethink their marketing to cater for people who have delayed getting medical help due to Covid-19 fears.

Worries about contracting the virus have made as many as 29% of people avoid seeing a doctor or going to hospital despite having a known medical condition, according to results of research this week.

Zegami, an Oxford-based medical image analysis platform, says its research reveals that as many as 254,000 people with cancer may have avoided seeking help. Zegami has recently developed a system to analyse large numbers of mammograms and identify abnormalities

It also found that 16% of people believe they have developed a medical condition since the Coronavirus crisis started but decided not to see a doctor.

Again, this was because of fears about Covid-19. Some 101,000 people believe their condition could be cancer, it believes.

Jane Braithwaite

A private practice marketing expert called the figures ‘terrible’ and told Independent Practitioner Today that private consultants and GPs should gear up to promote their services to thousands of ‘the missing’.

Jane Braithwaite, managing director at Designated Medical, said: ‘We know people are not getting the treatment they need or getting diagnosed. There will be patients searching for private doctors to look after them because the NHS is playing catch-up.

‘Independent doctors need to think how they can get the message over of what they can offer to patients. People will be anxious about costs and treatment because they’ve been NHS in the past.

‘Private doctors, clinics and hospitals need to acknowledge the issues, recognise patients may be looking at their websites for the first time and reassure how they will look after these patients. 

‘It needs to be about giving the best care and managing the cost of it. A doctor who wants to get the message across needs to say they are aware of the cost fears and, acknowledging this is a concern, demonstrate they will offer a service that makes it a worthwhile investment.’   

Of those people who believe they have developed medical conditions during the crisis but have not sought a medical diagnosis for fear of catching Covid-19, 22% say it is linked to their mental health, followed by 13% who say it is a skin condition.  

Some 7% fear they have developed a heart condition during the crisis and 1% – nearly 101,000 people – think they may have cancer, says Zegami.

Chief executive Roger Noble said: ‘Our findings are very alarming.’

Zegami commissioned the market research company Consumer Intelligence to survey 1,021 people from across the UK, representing the UK’s demographic profile. Interviews were conducted online between 13 and 16 November 2020.      

Medical condition  Estimated number of adults in the UK who have been diagnosed with this medical condition but have avoided seeing their doctor/going to hospital during the crisis to reduce their chances of catching Covid-19
Mental health related 3.16m
Skin condition 2.14m
Eye condition 1.38m
Heart condition 1.12m
Ear condition 1.1m
Broken bones 560,000
Cancer 254,600
Other/prefer not to say 8.25m
Guide to delivering superior patient experience in private practice: Delivering Excellence Consistently

Guide to delivering superior patient experience in private practice: Delivering Excellence Consistently

To deliver a great patient experience, you need to deliver excellence consistently.  Every single encounter with your patient makes a difference. To set the scene, I would like to use the words of the great rock musician Bruce  Springsteen: ‘Getting an audience is hard. Sustaining an audience is harder. It demands a consistency of thought or purpose and of action over a long period of time.’ This quote obviously relates to producing music and performing, but his emphasis on ‘consistency of thought or purpose and of action over a long period of time’ is equally true for your focus on your patients.

There is plenty of evidence that a long-term sustained focus on any area leads to improvement and that is what you are aiming to achieve in your own practice, clinic or hospital. In your work with patient experience, you started by defining your patient experience strategy, setting out your vision, which forms your guiding map of what you want your practice to be and setting your objectives to achieve in order to have this vision. In last month’s article, we focused on measuring patient experience, discussing the various methods of doing so, including surveys and focus groups, and the importance of capturing and presenting the data in a format that can be easily understood and used.

Identify what patients are telling you.
The next step in the process is to reflect on the findings from the measurement activities to fully understand what your patients are telling you. Identify the highlights and low- lights. You will celebrate the high- lights with your team, as these show the respects in which you are delivering a very positive experience for your patients. The lowlights are where you will need to focus more attention, as these are the identified areas for improvement. Even if all your results are good, I would encourage you to focus on the lowlights. The results may not seem to be disappointing, but there is always room for improvement and focusing on consistent improvement is what you are aiming to achieve. I would suggest choosing three lowlights and create an improvement plan for each of these. The time-scales can vary, but a quarterly plan with monthly review points would allow enough time to deliver and measure improvement, while the monthly reviews will ensure you and your team retain a focus on following up the actions and improving patient experience. The monthly reviews will come around very quickly.

Take ownership.
Agree who will take ownership of the improvement plans and who will develop them and manage their progress. I would suggest the overall owner is a senior individual within the team to ensure the right level of focus is given and that actions can be delegated with authority. But you may want to choose a team member to create the actual improvement plans and own the management of the process.

How will your improvement plans be developed?
Every individual who interacts with your patients, from your marketing manager through to the receptionist at the hospital where you operate, is a member of your own patient experience team. But it may not be possible to involve every individual in the development of the improvement plans, although, ideally, you want to involve as many as possible. Involving people at the creation stage is more likely to result in their buy into the process. The best method might be to set up a 30-minute team video call, but, prior to the meeting, circulate the results of your survey, high- light the three lowlights you are going to focus on and ask everyone to come to the meeting prepared to suggest ways to improve. During the meeting, everyone should be encouraged to contribute their thoughts and ideas, and this is more likely to occur in an open culture where individuals know that their input is valued and will be considered seriously. In an open culture, you will receive lots of suggestions and you will need to consolidate on a few actions which you all agree will deliver the best results. For those who are unable to take part in these early discussions, ensure you invest time in communicating your plans with them and giving them the opportunity to contribute. Your improvement plans are basically action plans describing what actions will be taken, by whom and by when. They should be short, very clear and easy to review. Many of you will be familiar with the SMART methodology: Specific, Measurable, Actionable, Realistic, Timescales and this would be a good tool to use. Your success will be measured when you next review your patients using the measurement strategies you implemented previously. If you are running ongoing surveys, you will be able to review the results monthly. If you are running one-off surveys from time to time, your implementation plan should include an action to run a new survey to measure improvement in the key focus areas, ideally quarterly.

Barriers to improvement
There is much research to show that middle managers can be a barrier to the improvement of patient experience, and the reason for this relates to their objectives not being aligned. The leaders and senior members of organisations are committed to improvement and intrinsically believe that it is vital. The front- line staff are engaging with patients every day and they want to deliver the best experience possible. But often middle managers are tasked with making the business more efficient and more profitable and this does not lead to a focus on improving patient experience. To engage middle managers fully, their objectives and key performance indicators need to include goals for improvement in patient experience.

Embedding an improvement culture
If you follow this plan, you will be reviewing the progress of your actions in your improvement plans monthly and measuring for improvement on a regular basis, ideally quarterly. Every three months, you can review your highlights and lowlights and change the focus of the improvement plans, if appropriate. Once each year, you can invest time with your team reviewing your patient experience strategy. Is your vision still relevant? Are your objectives and your measurement criteria still correct or do they need refining?

Patient expectations do evolve over time
The experience of living through 2020 has taught us many things, but one important lesson is that change is inevitable and can be drastic. The growth in telemedicine has been phenomenal and is a good example of how delivery of the patient experience can alter, and very quickly. Not so long ago, our patients would regularly pay their invoices in person by cheque and we would do a weekly bank visit to pay them in, and then BACS transfers became more popular. Nowadays, it is common for patients to receive a text message containing a link to a payment page where they pay by credit card. I believe that online appointment booking will become increasingly popular over coming months and we will make greater use of video in a broader range of applications. While we cannot predict everything that will happen as we adapt to new ways of working, we can ensure we deliver a positive patient experience. This process described here, of continual review, will ensure that the focus on improving patient experience is embedded in your team culture and happy patients will equate to the ongoing success of your practice.


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