The GP Practice Staff Wellbeing Guide

A practical guide for GP Practice Managers, partners and workforce leads

Staff wellbeing in general practice is shaped by the conditions in which employees work. Workload, communication, management support, working relationships and the ability to raise concerns all influence how staff experience their roles.

For GP practices, managing wellbeing effectively means understanding these conditions, identifying potential risks and responding before problems become more difficult to address.

This requires more than providing wellbeing resources or conducting an occasional staff survey. Practice leaders need a reliable understanding of workforce pressures, supported by meaningful employee feedback and relevant operational information.

The aim is not to eliminate every difficulty associated with working in general practice. Many pressures are outside an individual practice's control. It is to recognise where working conditions can be improved, provide appropriate support and ensure workforce concerns form part of routine management decisions.

• What does staff wellbeing mean in a GP practice?

  Staff wellbeing encompasses the physical, psychological and social aspects of employees' working experience. In general practice, it is influenced by both the demands of delivering patient services and the way the practice is organised and managed.

  Different staff groups face different pressures.

  Reception teams regularly manage high volumes of patient contact, competing requests and difficult conversations. Administrative staff may experience pressure from correspondence, prescription processes, referrals and other time-sensitive tasks.

  Clinical staff carry responsibilities associated with patient care, professional standards and clinical decision-making, often alongside demanding appointment schedules.

  Practice Managers must balance these competing demands while maintaining service delivery, supporting employees and meeting operational responsibilities.

  These differences matter because a practice can have a positive overall working environment while particular teams experience significant difficulties.

  For example, staff may report supportive colleagues and good relationships with management but still struggle with unrealistic workloads or insufficient time to complete essential tasks.

  A useful approach to wellbeing therefore considers individual experiences alongside the wider organisational conditions that influence them.

• How can Practice Managers recognise emerging wellbeing problems?

  Workforce concerns are not always raised formally. Changes in attendance, morale, communication or performance may provide early indications that employees are experiencing difficulties.

  Practice Managers often become aware of these changes through everyday contact with staff.

  A previously engaged employee may become less involved in team discussions. Administrative backlogs might increase, or colleagues may begin reporting difficulties completing routine work. Disagreements between teams may also become more frequent.

  These observations do not automatically indicate poor wellbeing. Individual circumstances, seasonal demand, changes in patient activity and temporary staffing issues can all affect how a practice operates.

  The important distinction is between isolated difficulties and developing patterns.

  Potential indicators to review include:

  • Recurring overtime: Employees regularly working beyond their contracted hours to complete routine tasks.

  • Sickness absence: Changes in attendance that may warrant further consideration alongside other workforce information.

  • Administrative backlogs: Persistent delays that could indicate capacity, training or workflow problems.

  • Staff turnover: Employees leaving or expressing dissatisfaction with their roles or working arrangements.

  • Workplace relationships: An increase in disagreements, grievances or communication difficulties.

  • Staff engagement: Reduced participation in meetings or reluctance to contribute ideas.

  • Working arrangements: Employees regularly struggling to take appropriate breaks or manage competing responsibilities.

  Managers should avoid drawing conclusions from individual indicators without understanding the circumstances.

  For example, increasing administrative backlogs may reflect changes in referral processes rather than reduced employee engagement. Equally, a period of low sickness absence does not necessarily mean employees are coping well.

  Reviewing patterns over time provides a more reliable basis for deciding whether further investigation or management intervention is appropriate.

• What should GP practices measure to understand staff wellbeing?

  A useful approach to measuring wellbeing focuses on the aspects of working life that influence employees' ability to perform their roles and feel supported.

  The Health and Safety Executive's Management Standards provide a recognised reference point for understanding work-related stress.

  They identify six areas of work design: demands, control, support, relationships, role and change.

  For general practice, these can be translated into practical management questions.

  • Demands: Is the volume and complexity of work reasonable in relation to available staffing and time?

  • Control: Do employees have appropriate input into how their work is organised?

  • Support: Can staff access management guidance and assistance when difficulties arise?

  • Relationships: Are employees treated respectfully, and are workplace disagreements addressed appropriately?

  • Role: Are responsibilities clearly defined, particularly where clinical and non-clinical duties overlap?

  • Change: Are employees adequately informed and supported when operational arrangements change?

  Practices may also choose to examine confidence in leadership, recognition, professional development and opportunities for employees to contribute suggestions.

  The information collected should reflect the practice's actual management needs.

  For example, a practice introducing a new telephone system may want to understand whether reception employees have sufficient training and whether changes have affected their workload.

  Another practice experiencing recruitment difficulties may need to examine working patterns, role expectations and reasons employees choose to leave.

  There is little value in collecting extensive workforce information unless management understands what it is intended to reveal.

• How can GP practices collect meaningful staff feedback?

  Effective staff feedback arrangements should give employees appropriate opportunities to share their experiences, including concerns they may not feel comfortable raising during routine conversations.

  There is no single method suitable for every practice.

  Anonymous staff surveys provide a structured way to gather views across different areas of employment. They can be particularly valuable for identifying recurring themes relating to workload, communication and management support.

  Individual meetings allow employees to discuss personal circumstances or operational difficulties in greater detail. These conversations can help managers understand issues that would be difficult to explore through survey questions alone.

  Team discussions are useful for identifying practical problems with everyday working arrangements, such as task allocation, communication between departments or changes to procedures.

  Confidential reporting arrangements provide an additional route for concerns requiring particular sensitivity, including serious workplace or safety matters.

  The most suitable combination will depend on practice size, existing communication arrangements and the nature of the information being sought.

  Protecting anonymity in small practices

  Anonymity requires particular consideration in general practice, where teams may contain relatively few employees.

  Removing names from a survey does not necessarily make responses anonymous. Job titles, working patterns and free-text comments may still reveal an individual's identity.

  For example, publishing separate findings for a small nursing team could make individual responses identifiable.

  Practices should consider whether demographic information is necessary, restrict access to sensitive responses and avoid sharing results in a way that identifies employees.

  Where staff feedback involves personal data, UK data protection requirements apply, including relevant principles of data minimisation, confidentiality and appropriate access.

  Employees should understand how their information will be handled before providing it.

• How should managers interpret staff wellbeing survey results?

  Survey findings should be treated as evidence requiring interpretation rather than definitive measurements of organisational performance.

  An overall score can provide a useful indication of employee sentiment, but it may conceal important differences between aspects of working life.

  For example, employees might report high satisfaction with their colleagues while expressing significant concerns about workload or management communication.

  Looking only at the overall result risks overlooking these distinctions.

  Managers should consider several factors when reviewing findings:

  • Recurring themes: Are particular concerns appearing consistently across responses?

  • Changes over time: Have results improved or deteriorated compared with previous feedback?

  • Differences in experience: Are there indications that some areas of work face greater difficulties than others?

  • Employee comments: Do written responses help explain the reasons behind survey scores?

  • Operational circumstances: Have staffing changes, new systems or unusual service pressures influenced the findings?

  It is also useful to compare survey themes with relevant management information.

  If staff frequently report excessive workload, the practice could examine whether overtime, vacancies or unfinished tasks support that concern.

  However, a negative response does not automatically establish a systemic problem, and a favourable result does not demonstrate that all employees are satisfied.

  Particular care is needed when analysing small groups, where detailed breakdowns could compromise confidentiality or create misleading conclusions from very few responses.

  The purpose of interpretation is to understand what the findings suggest and determine whether further discussion or investigation is necessary.

• How can GP practices turn staff feedback into meaningful improvements?

  The value of workforce feedback depends on how effectively it informs management decisions.

  Once concerns have been identified, practice leaders should determine which issues require action, what changes are feasible and who is responsible for implementing them.

  Some improvements may be relatively straightforward.

  For example, employees reporting inconsistent communication about rota changes might benefit from clearer notification arrangements or a more reliable process for approving amendments.

  Other concerns may require wider operational decisions.

  Persistent workload pressures could indicate a need to review staffing capacity, redistribute responsibilities or reconsider how particular services are organised.

  Not every concern can be resolved immediately, particularly where additional expenditure or partner approval is required.

  A proportionate improvement process should include:

  • Identifying the main issues requiring attention.

  • Considering the underlying causes and available options.

  • Agreeing realistic actions and assigning responsibility.

  • Establishing appropriate timescales for implementation.

  • Reviewing whether the changes have addressed the original concern.

  Staff should receive an appropriate explanation of the decisions made, including where management cannot implement a requested change.

  This helps employees understand how their contribution has been considered without creating unrealistic expectations.

  Where concerns remain unresolved, they should continue to be reviewed through the practice's normal management and governance arrangements.

• How does staff wellbeing relate to CQC expectations?

  Workforce wellbeing is relevant to how CQC considers leadership, organisational culture, staffing arrangements and the ability of employees to raise concerns.

  Within CQC's published assessment framework, the well-led key question includes quality statements concerning shared direction and culture, freedom to speak up, workforce equality, diversity and inclusion, and governance.

  These areas can overlap with how practices manage workforce concerns and support employees.

  For example, evidence that staff feel able to raise issues may be relevant to understanding the practice's organisational culture.

  Similarly, records showing that leaders review staffing risks and address identified problems may help demonstrate aspects of workforce governance.

  Potential sources of supporting evidence include:

  • Staff feedback findings and management responses.

  • Records of team discussions and workforce meetings.

  • Work-related stress risk assessments.

  • Workforce improvement plans.

  • Training and development arrangements.

  • Records demonstrating how concerns have been escalated and addressed.

  However, documentation should accurately reflect what happens within the practice.

  A completed survey does not independently demonstrate effective leadership, and the existence of a policy does not establish that employees feel supported.

  Practices should also distinguish regulatory expectations from management approaches they have chosen to adopt.

  CQC does not prescribe the purchase of a particular commercial staff wellbeing survey product.

  The central consideration is whether the practice can demonstrate appropriate leadership, recognise workforce risks and maintain effective systems for managing concerns.

• What commonly goes wrong with GP practice wellbeing initiatives?

  Wellbeing initiatives can have limited impact when they address the symptoms of workplace pressure without considering its causes.

  For example, introducing additional wellbeing resources may provide employees with useful support, but it will not necessarily resolve persistent understaffing, excessive administrative workloads or unclear responsibilities.

  Individual support and organisational improvements serve different purposes. Both may be appropriate, but they should not be treated as interchangeable.

  Other difficulties can arise when practices:

  • Introduce surveys without a clear purpose or plan for using the findings.

  • Ask employees to provide feedback too frequently without allowing time for meaningful improvements.

  • Concentrate on favourable overall scores while overlooking specific concerns.

  • Assume that all wellbeing problems arise from individual resilience rather than working conditions.

  • Overlook employees who work part-time or across different sites.

  • Introduce changes without considering their impact on existing roles and responsibilities.

  There is also a risk of placing excessive responsibility on the Practice Manager.

  Although Practice Managers oversee substantial aspects of daily operations, decisions about staffing investment, service capacity and strategic priorities may sit with GP partners or other leadership arrangements.

  Effective workforce management requires responsibilities to be clear and decisions to be made at the appropriate level.

• What should a Practice Manager check?

  A periodic review can help establish whether the practice has appropriate arrangements for understanding and managing staff wellbeing.

  Practice Managers may wish to consider the following questions:

  • Are the main sources of pressure affecting clinical and non-clinical teams understood?

  • Can employees raise workplace concerns through appropriate and accessible channels?

  • Are working arrangements regularly reviewed to identify avoidable difficulties?

  • Is relevant workforce information examined for changes or emerging risks?

  • Are survey and feedback processes designed to protect employee confidentiality?

  • Do managers understand how workforce concerns are considered within practice governance?

  • Are responsibilities for implementing improvements clearly allocated?

  • Do employees receive appropriate information about changes affecting their roles?

  • Are unresolved concerns monitored and escalated when necessary?

  • Is the practice able to assess whether previous workforce improvements have been effective?

  These questions are intended as a practical management aid rather than a formal regulatory assessment.

  Their value lies in identifying areas that require attention and helping practices establish consistent workforce management arrangements.

• Common questions about GP practice staff wellbeing

  Do GP practices have to carry out staff wellbeing surveys?

  There is no general statutory requirement for GP practices to use a particular staff wellbeing survey. However, employers have duties to assess and manage work-related stress risks. Surveys are one method of gathering information that may support this responsibility.

  How often should a GP practice survey its staff?

  There is no universally appropriate frequency. An annual survey may be suitable for some practices, while others may benefit from shorter, more regular feedback exercises. The approach should reflect the practice's size, circumstances and ability to use the information effectively.

  Should staff wellbeing surveys be anonymous?

  Anonymous surveys can encourage employees to discuss sensitive concerns, but practices must consider whether responses could identify individuals indirectly. This is particularly relevant in smaller teams.

  Should staff survey findings be shared with employees?

  Providing an appropriate summary of findings and management decisions is generally good practice. Individual responses and confidential information should be protected.

  Can staff wellbeing information support CQC assessments?

  Workforce feedback and related management records may contribute to evidence concerning leadership, organisational culture and governance. Their relevance depends on what they demonstrate about the practice's actual arrangements and actions.

• What should the practice do next?

  A useful starting point is to review how workforce wellbeing is currently understood and managed within the practice.

  Rather than introducing multiple new initiatives, practice leaders could focus initially on four actions:

  1. Establish the current position. Review the workforce information already available and identify where further understanding is needed.

  2. Consider the employee experience. Ensure staff have suitable opportunities to discuss working conditions, particularly where existing information suggests difficulties.

  3. Prioritise manageable improvements. Agree a limited number of practical changes, involving GP partners or other decision-makers where necessary.

  4. Evaluate the outcome. Revisit the issues identified and establish whether the changes have made a meaningful difference.

  Workforce wellbeing should not be treated as a separate activity undertaken only when concerns become serious or external scrutiny is expected.

  It is part of effective practice management.

  By developing a clearer understanding of staff experiences and using that information to inform routine decisions, GP practices can create a more consistent and constructive approach to supporting their workforce.