Getting the best out of your team

Getting the best out of your team

As leaders, we want to lead high-performing teams and, as team members, we want to be working as part of them. 

Working in a great team is an absolute pleasure and has an enormous impact over how we feel about our work and the company we are employed by. 

Of course, the opposite is also true and working in a dysfunctional team is deeply negative and has a huge impact on performance. It can be enough to encourage individuals to leave and pursue other options.

So how do we establish a great team, how do we lead one and how do we play our part in contributing to the success of the team?

Let’s start by exploring some examples of great teams. The sporting world is a good place to begin. Anybody who is loyal to a particular team or club will know all too well the highs and lows associated with team performance. 

When a team is failing, the manager often gets put under enormous pressure and the result can be a swift departure, as experienced by Chelsea and Tottenham Hotspur FCs’ head coaches Frank Lampard and José Mourinho this season. 


Winning strategy

Many of us have recently enjoyed the Six Nations rugby championship and each team taking part has been analysed by professionals, the media and all of us at home watching. Each team has its own characteristics, with Wales being admired for their grit and determination while England was heavily criticised for a lack of discipline. 

Back in 2003 when the England ruby team won the Rugby World Cup, the team was led by Sir Clive Woodward, who helpfully shares his winning strategy. 

Woodward says that ‘great teams are made up of great individuals’ and he focuses on creating a winning culture and claims a formula for creating ‘champion individuals’.

Woodward lists four key criteria to create a winning team:

Talent – individual talent;

Teachability – ‘It’s often the most experienced person who is unteachable’;

Pressure – the warrior spirit;

Will – commitment to win. 

In his 2003 team, Woodward describes having five champions and ten warriors, and he highlights the importance of coaching on two levels: for individuals and for the team together.  

Woodward’s approach was clearly successful and he continues to support sporting organisations but also offers coaching and consultancy to business executives. 


Significant improvement

Another team strategy brought to our attention is the ‘aggregation of marginal or incremental gains’. The strategy works on the premise that if we can improve every aspect of a team’s performance by 1%, the overall result will be a significant improvement. 

This approach was highly publicised following the success of the British cycling team in 2008 and 2012 and although its achievements are being questioned, the strategy is still popular in the business environment. 

One of my personal favourite sporting strategies that has been embraced by business is described in the book Will it make the boat go faster? as described by Ben Hunt-Davis in which he documents how his team adopted this strategy and subsequently won the gold medal in the rowing eight at the 2000 Olympics in Sydney.

I like this, as it is simple and can be used to immediately ensure everyone on the team is on the same page. 

In business, we might use this strategy to achieve a project within tight time-scales or to focus on a particular aspect of our service – for example: ‘Does it make the patient experience better?’ or ‘Does it make the treatment safe?’ It’s a great way to ensure focus and gain momentum to achieve short- and medium-term goals. 


Learning opportunities

These examples of sporting successes in team performance provide plenty of interesting learning opportunities that can be adapted for business and we may pick up ideas from numerous sources as we create our own leadership and team management strategies. 

Each of us can use best practice to influence our leadership style, but, ultimately, our approach will be unique to us and our personalities. 

As we build our own style, it is important to break down the aspects of teamwork and ensure we consider each aspect to build a good all-encompassing approach. 

Reflecting back to the wise words of Sir Clive Woodward, we can consider the four elements of team success that he bases his approach on.

1. Talent

To create the greatest team, we want to have the greatest leader and the most talented individuals.While this might be realistic for Chelsea FC, most of us are restrained by factors such as money, availability of talent, and geography. 

In the real world, what we really need to aim for is the most talented individuals available to us and ensuring that each individual delivers to the best of their ability.  

A team also requires a group of people with differing but complementary talents. 

In a healthcare setting, our teams potentially comprise doctors, nurses, administrative support and business managers, all of whom have very different skills and have been educated differently. 

All these individuals must find a way to work together to the benefit of the patient. As well as having differing skills, a team will also be home to lots of different personality types and character types. 

Some people are eternal optimists, always anticipating the best possible outcome and seem oblivious to any potential barriers. Others will be the complete opposite, preferring to plan for the worst-case scenario so that all bases are covered and prepared for. 


Opposite types

When two people of opposite types such as these come together, they can either create a perfectly balanced partnership or they can find it impossible to work together and hit a brick wall. 

Another potential conflict can arise when one person is an ideas person and another is a detailed planner. The detailed plan that is essential to one person can be viewed as a barrier to progress and a time-wasting activity to the person who has the great idea and wants to get on with delivering it. 

Again, a balance of these two styles is ideal, but how do we bring different personalities such as these together to work collaboratively? 

In last month’s article, I talked about leaders needing to develop self-awareness and to understand their natural style. I suggested using psychometric profiling tools such as Myers Briggs and C-me profiling and, again, these tools are equally relevant to individuals working together as a team. 

Once an individual understands their own style and also the natural style of others on their team, they can learn the right way to communicate and work with one another to achieve success. 

The ‘ideas person’ learns that by listening to the detailed-oriented individual, their idea has a far greater chance of success as a result of the detailed plan that will be developed ensuring that every outcome is prepared for. 


2. Teachability 

An ability and willingness to learn is an important attribute for all team members. 

Too often, we associate this with more junior team members, but actually it is relevant to even the most senior members of a team and Woodward is quite right when he states: ‘It’s often the most experienced person who is unteachable’. 

To work well as a team, every individual needs to be prepared to adapt their ways of working for the good of the team. The well-known management phrase: ‘It’s my way or the highway’ might feel powerful, but what if there is a better way?

3. Pressure 

When Woodward says pressure, what he really means is the ability to perform under pressure and he believes the only way to ensure an individual and therefore the team can succeed under pressure is to practice by exposing the team to pressure regularly. 

He uses role play requiring the team to work through every eventuality to ensure they know exactly what to do in each situation. This easily relates to complex surgical procedures and can also be adapted to the business environment – for example, the launch of a new service, clinic or company. 

Personally, I would also argue that all teams must think about how to recover from being under pressure and build resilience. It is clearly not possible for any individual or team to perform under constant pressure. 

We need to build in mechanisms for recognising long periods of extreme pressure and have plans to relieve it and allow recovery. 

This may involve adjusting holiday allowance, time off in lieu or activities within the working day to allow for recuperation, but they must be built in. This will be the topic for my next article. 


4. Will 

A team needs to be driven by an agreed goal or objective and to share a joint motivation to succeed and achieve the goal. This is why the strategy of ‘Will it make the boat go faster?’ is so effective, as it aligns the whole team to one clear, simple goal. 

If a team has one or more members who doubt the goal is achievable, then this will have a draining impact on the team’s morale and reduce each person’s motivation to succeed. 



It is said that ‘teamwork makes the dream work’ and we all agree wholeheartedly, but achieving the dream requires an investment of effort on a consistent basis. 

The most talented individuals might be individually amazing, but unless they can work together as a team, their talents can be wasted. 

Humans are tribal and evolved working together in teams, intrinsically knowing it makes them more effective and ultimately our lives more enjoyable. 

In recent months, we have seen an increasing number of reports of the effects of Covid on mental health and this is particularly apparent within the health care community. 


You can learn leadership

You can learn leadership

Designated Managing Director Jane Braithwaite continues her ‘The power of people’ series by exploring the ways in which leadership skills can be enhanced and highlights the support and tools available to help achieve this.

Some leaders make leadership look easy. They come across with both charm and sincerity, generating enthusiasm and support for their ideas and attracting a loyal following. 

We watch these impressive individuals in awe, admiring the seemingly natural ability they were lucky enough to be born with. 

To a certain extent, it may be true that some people have personality traits well suited to a leadership role, but leadership skills can be learned, developed and improved both by experience and more formal training.

Good leaders energise their teams to succeed and, in every organisation, the ability to do this is an advantage, enabling them to achieve more and to progress at pace. A lack of leadership leads to slow decisions or, worse, no decisions and a lack of progress. 

In the past, we have spoken about our three ‘C’s of leadership: 

Clarity – Clarity of purpose and a relentless determination to achieve that purpose; 

Communication – To communicate effectively with the team and generate enthusiasm to achieve the team’s purpose; 

Care – A genuine dedication to the well-being and development of the team. 

When we consider the great leaders of our time – for example, Winston Churchill and Nelson Mandela – we see a consistently strong sense of purpose or cause and an absolute determination to achieve success. 


And looking at the skills of business leaders such as Tim Cook of Apple and Sheryl Sandberg of Facebook, we recognise the same traits of a strong sense of purpose, but also a huge commitment to building the best team, empowering the team and recognising individuals for the success they achieve. 

Great example

A leader who has taken centre stage in the last few months is Brigadier Phillip Prosser, who stepped up to the podium as part of the Government’s Covid campaign on 7 January. 

Originally from Wales, Prosser was commissioned into the military in 1992 having completed a degree in engineering. He went on to serve on several occasions in Bosnia, Iraq and Afghanistan prior to serving on home soil as part of the PPE distribution campaign in 2020 and most recently taking lead of the logistics of the campaign to roll out the Covid vaccine. 

As he admitted himself, he has ‘never battled a virus before’ and so provides a great example of how strong leadership skills can be applied to very different situations. 

Prosser talks about his current role as a ‘noble purpose’ which marks ‘the beginning of the end of Covid’. This ‘noble purpose’ is his cause and his determination to succeed is obvious and it is clear he has a very strong sense of purpose in his role as the leader of this current campaign. 

Strong, clear communications are demonstrated as he delivers key messages with absolute clarity, and while there are no wasted words, he commands trust and builds a belief that he can deliver as illustrated in the following statement. 

‘It is my role to deliver combat supplies to UK forces in time of war. My team are used to complexity and building supply chains at speed in the most arduous and challenging conditions. We aim to deliver vaccine as soon after it is supplied as possible, not leaving vast quantities in the warehouse – it needs to be in arms not on shelves.’

Factors to succeed

When asked about achieving such ambitious targets, he describes three factors needed to succeed.

 Noble purpose;

 Dynamic plan; 

 Amazing teams.

In every conversation I have witnessed, Prosser raises the profile of the NHS team alongside his own team, referring to two world-class institutions and describing the ‘heroic efforts’ being made. 

He appears to be a leader who would step back from congratulations and deflect the compliments and recognition towards the team that he leads. 

How does the military train such effective leaders? Most significantly, they deliver extensive leadership training that is very carefully planned and far more comprehensive than we typically see in business and other government organisations. 

Promoted without training

In many businesses, if someone is good at doing their functional role, they are often promoted into a leadership role with very limited training and rely on their natural ability rather to lead.

The ethos of the military is to serve, and doing so is a duty that affects the style of their leaders. A military leader takes responsibility for the well-being of their team and their extended community and prioritises their need. 

In a crisis, the team must be motivated and inspired by their leader and they must also have total trust and confidence in them. Often their lives will depend on their leader.

The style of leadership, exhibited by the military is known as transformational leadership, and was initially introduced by leadership expert James MacGregor Burns, who gives us this definition.

Transformational leadership occurs when one or more persons engage with others in such a way that leaders and followers raise one another to higher levels of motivation and morality.

Transformational leadership is widely believed to be the optimal style of leadership largely because most individuals want to experience this type of leadership in their professional lives. Trans­formational leaders inspire and motivate their team and trust them to make decisions, giving them a greater opportunity to be creative and make changes.  

How do we develop our leadership skills? 

The starting point for any leader must be self-knowledge and self-awareness. Understanding how we naturally behave as leaders and our strengths and weaknesses is the only sure-fire way to develop our skills and to become better. 

Once we understand our current style, we can identify behaviours to improve, explore training and additional support to help us learn to improve. 

There is an overwhelming amount of information regarding leadership development which is evidence in itself of how many of us value the development of these skills, but it is hard to fathom where to start.

Developing self-awareness

Most of us believe we have a strong awareness of how we come across as individuals and leaders, but, sadly, this is often not the case and how others see us is often quite different to how we perceive ourselves to be. 

For example, you may believe you communicate regularly with your team and see yourself as a strong communicator, but your team may feel you are quite closed and need to communicate more. 

This is very common feedback from teams when asked about their leader. Many of us have blind spots and being made aware of them is the basis for improvement. Improving self-awareness allows us to understand how others see us, identify any blind spots and allows us to choose to act in some way to improve. 

Embarking on a journey to develop greater self-awareness is brave and it is important to remind ourselves that there is no perfect person, no perfect leader and no perfect behaviours. The aim is improvement overall and being the best leader possible for us. 

Psychometric tests

One of the most commonly used tools for improving self-awareness in leadership are psychometric tools; for example the Myers Briggs Type Indicator (MBTI). 

MBTI is widely recognised to be incredibly valuable and has been used for over 50 years. The tool divides everyone into 16 personality types represented by a combination of four letters as follows:

 Extroverted (E) vs Introverted (I);

 Sensing (S) vs Intuition(N);

 Thinking (T) vs Feeling (F);

 Judging (J) vs Perceiving (P).

I really like Myers Briggs, but the terminology used is hard to remember (am I ENTJ?) and so I prefer to use a tool called C-Me profiling. 

The concept is similar, but the results are based on behaviours rather than personalities and four colours representing these different behaviours. It is therefore much easier to remember, as it’s visual. I am a yellow and red. 

One of the other benefits is that a team familiar with C-Me can use the colours as a ‘language’ to help them work well together and communicate more effectively. 

360-degree feedback

The concept of 360-degree feedback is to gather comments from several sources to be assessed and analysed to identify recurring trends and therefore generate useful data to improve self-awareness and identify areas for personal development. 

Ideally, you would include a good number of participants, preferably 15 people, with differing relationships to you. 

Aim to choose some contributors who are senior to you, members of your peer group and members of your team so that you really get a 360-degree view. In some circumstances, you might also choose to invite patients to take part, although this is not always relevant when assessing leadership skills. 

Many doctors will be familiar with the 360-degree feedback requirement of the GMC validation, which is indeed similar but focuses more on your behaviour as a doctor as opposed to as a leader.

There is no doubt that implementing 360-degree feedback is admin-heavy and you will need to find a good system to support this. There are numerous tools available and specialist companies available to help. 

Coaching and development

Greater self-awareness will highlight personal development areas, and these will obviously differ for each individual. 

Once you have a greater understanding of the leadership behaviours you would like to focus on developing, it is time to look for support to help you and there is a vast amount of support available. 

The number of books and podcasts focusing on leadership is quite astounding and for anyone who is willing and motivated to invest time in reading and listening, so much can be learned in this way. 

Most of us are time poor and we need motivation to keep us on track and may wish to consider engaging a personal coach to support this journey. 

Again, the number of coaches available is overwhelming and it is worth investing some serious time into finding the right person with the right skills for you. 

Training programmes

Many universities and independent companies run leadership training programmes in a traditional classroom setting or on a virtual basis. 

This formal approach can be valuable if you are motivated to gain a recognised qualification that may help you further your career or perhaps you would value the opportunity to step outside your normal environment and dedicate some time to learning. 

These courses do require a significant investment in time attending the course itself and completing the set work and, of course, the cost of the course itself.  


Becoming a better leader is an objective shared by many of us and there is definitely a lot of support to help us achieve this goal. 

To progress requires an investment of our time to develop greater self-awareness, being honest with ourselves and being brave, potentially listening to feedback that opens blind spots that are unknown and unexpected. 

Choosing to act and improve requires self-motivation and commitment but doing so not only improves individuals as leaders in the workplace, but potentially has benefits in our personal lives. 

The best leaders, of course, appreciate that as well as developing their own behaviours and leadership skills, they also need to create and manage amazing teams and next month we will explore this topic, discussing tools and techniques to help leaders develop high-performing teams. 



The qualities you need to take the lead

The qualities you need to take the lead

When it comes to the subject of people management, every organisation aims to create high-performing teams and one of the key contributing factors to success is leadership and management. We know that good leadership and management is vital to gain the greatest contribution from our people, but how do we define a good leader and how does a great leader differ from a great manager?

We all have vivid personal experiences of leaders and managers and can recount stories of great bosses and those who were not so great, but articulating exactly what characteristics make a great leader or manager is hard. 

Who is the best manager you have ever worked for? Try articulating concisely what made them great? 

I bet most people find it much easier to describe the characteristics of their worst manager rather than their best and can offer countless examples of their failures and how truly awful they were to work for. 

It is much harder to state clearly what makes a great manager so great. They just are!

But to be a good manager or leader and to improve, we need to understand what skills are most important, what we want from our leaders and what our teams need from us.

 Designated Medical Leadership

 The difference between leadership and management

Leadership and management are different in nature.

A leader sets a vision and the direction for the team and motivates each individual team member to join together with others as one team to achieve the set vision. People follow leaders.

A manager manages the process of the work, working with the individuals in the team to ensure they are able to make their contribution in an efficient and effective manner. A manager drives for order and accountability, creating improving systems and processes.

Individuals within the team will be motivated to follow a good leader and to work with a good manager.


Characteristics of a great leader

A great leader inspires people and motivates them to act, setting the direction and the vision of where they are heading, even if they are not certain how they will get there.

Good leaders are often charismatic, engaging and outgoing, but there is, of course, an exception to every rule. 

They tend to cope well with chaos or a crisis situation and are able to determine a way forward and articulate that to others.

Leaders are good at handling change and developing confidence in others to initiate the changes.

They create ideas and engender enthusiasm to explore new opportunities and, in doing so, may be perceived as rule-breakers. You could argue that great leaders are of a more creative nature. 

In a crisis situation such as the all too familiar Covid pandemic, a leader will motivate the team to commit to working hard even when exhausted and build confidence that the goal will be reached despite the way forward lacking clarity.


Characteristics of a great manager

A manager manages the work of whatever nature and, by definition, requires a deep understanding of the operations of the business or team.

A good manager will be analytical, assessing how things are done and looking at ways to change and improve either to create greater efficiency or to achieve certain goals.

n almost any work situation, a good manager will also need to a be a good people person, able to relate to individuals on a one-to-one basis and as a team. 

Managers are good at creating and improving systems and process. They aim to create order and to simplify. They are problem solvers who desire stability and control.

The skills of leaders and managers are different, but to manage a business, clinic or team, the person in charge needs to have both leadership and management skills to some degree.


Examples of great leaders

During the Covid crisis, we have experienced first-hand some very high-profile leaders and managers in action. I will avoid naming any individuals to avoid tipping into a political debate, but I am sure it has become obvious to us that some individuals are better at leadership than management and vice versa.

Much has been written about great leaders over the years and, in time, I am sure we will read about the great leaders during the Covid pandemic. 

Any historical list of the greatest leaders is likely to include Nelson Mandela, Martin Luther King, Winston Churchill and Mahatma Gandhi and I am sure we can all name a few others. 

Each of the individuals I have included had a cause they were so passionate about, that their name became synonymous with that cause. Take, for example, Martin Luther King’s cause which is well known as his ‘dream’.

If we review the leadership characteristics of these individuals to look for consistencies that help us understand what makes them great leaders, in each case we see a relentless determination, incredible will power, courage and unfailing motivation even when tested to breaking point. 

As leaders, they each won the hearts and minds of their people, with Gandhi being remembered as ‘the father of his country’. In summary, we can deduce that key traits of a great leader are a clear cause, the ability to communicate that cause well, to create an enthusiastic following and an unfailing determination to achieve it. 


Great business leaders

It may feel more relevant to us to consider leaders within the business community, and any current list of the ‘greatest business leaders’ is likely to include the following people.

Tim Cook, chief executive of Apple;

Sheryl Sandberg, chief operating officer of Facebook;

Mary Barra, chairman and chief executive of GM Company;

Elon Musk, founder of PayPal and Tesla;

Warren Buffett, chief executive of Berkshire Hatha­way;

Bob Igor, executive chairman of Disney;

Reed Hastings, chief executive of Netflix.


There are some big names here, some of whom have become almost celebrity figures, but that does not detract from their capabilities as great leaders.

Again, we can review their leadership styles to understand what makes them the great leaders they are recognised to be and look for consistencies that allow us to learn from them.


Interestingly, the themes here differ from our earlier examples of great leaders where their commitment to their cause seemed to be the greatest factor.

While I am certain that each of these business leaders has a cause or a vision as we tend to refer to it in a business setting, but most of what is written about their leadership style is their approach to creating and managing their teams.

Take ownership 

They surround themselves with exceptional people and they empower these people to be innovative and take ownership.

They work hard to understand the strengths of the individuals within their teams and allow them to apply those strengths. 

They support and encourage, acting as an enabler and they praise their team members for their great work, making a point of not taking credit themselves. 

‘It doesn’t make sense to hire smart people and tell them what to do; we hire smart people so they can tell us what to do’ – Steve Jobs.


What also seems to distinguish them most is their decision-making process. They claim to make very few decisions themselves but encourage their teams to make the decisions, trusting their ability to do so, which has the added impact of ensuring their teams take ownership. They are clearly defining themselves as leaders and enabling their teams to do the managing.

Leadership and management are different and require different skillsets. We may feel that some people were born great leaders, but, in reality, their skills have been developed by life experience and formal training. 

It is possible for anyone to improve their leadership and management skills and the best starting point is improving self-awareness. 


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.

January Stay Connected

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