Why Staff Belonging Matters in General Practice

Staff belonging in general practice means employees feel accepted, respected and included as valued members of the practice team. It develops when people understand their contribution, have positive working relationships and believe they are treated fairly, regardless of their role, background or working arrangements.

For GP practices, belonging matters because delivering patient care depends on cooperation between clinical, reception, administrative and other staff. Employees need to feel that their work is recognised and that they can contribute to the organisation, even when they have different responsibilities or professional backgrounds.

A sense of belonging cannot be created simply through social activities or occasional recognition initiatives. It is shaped by everyday management decisions, team relationships and how employees experience the working environment.

Practice Managers can strengthen belonging by examining whether staff feel included, supported and respected throughout the organisation.

• What does staff belonging mean in a GP practice?

  Staff belonging describes the experience of feeling that you are a recognised and valued part of the organisation, rather than simply someone employed to complete a particular function.

  In a GP practice, employees may identify with their immediate colleagues but feel less connected to the wider organisation.

  For example, reception staff may have strong relationships within their team but feel that their contribution is overlooked when decisions about patient access are discussed.

  Similarly, employees working in administrative roles may have limited opportunities to contribute to discussions involving clinical colleagues, even when those decisions directly affect their responsibilities.

  Belonging does not require everyone to have the same experiences or opinions.

  A practice includes people with different qualifications, responsibilities and working patterns. These differences are necessary for effective service delivery.

  The important consideration is whether employees feel that their contribution is respected within that structure.

  Belonging can be reflected in whether staff:

  • Feel recognised for the work they undertake.

  • Experience respectful relationships with colleagues and managers.

  • Are included in relevant communications and decisions.

  • Have opportunities to contribute ideas and raise concerns.

  • Understand how their responsibilities support the wider practice.

  • Feel fairly treated regardless of their role or background.

  • Receive appropriate support when joining or moving within the organisation.

  These experiences are influenced by management arrangements, but also by how colleagues interact with one another.

  A welcoming working environment is therefore a shared responsibility, supported by consistent leadership.

• Why is belonging particularly important in general practice?

  General practice brings together employees with different responsibilities who rely on one another to provide coordinated services.

  Reception teams are often the first point of contact for patients. Administrative colleagues manage essential processes, while clinical employees provide assessment, treatment and ongoing care.

  Although responsibilities differ, the quality of communication between these groups can affect how effectively the practice operates.

  A sense of belonging can support cooperation by helping employees recognise that their contribution is part of a shared service.

  Difficulties may arise when professional or departmental boundaries become unnecessarily divisive.

  For example, reception employees may feel they are expected to manage patient dissatisfaction without sufficient recognition of the pressures involved.

  Clinical colleagues may feel that the demands of consultations and associated administrative responsibilities are not fully understood by other teams.

  These differences in experience do not necessarily indicate poor working relationships.

  However, where employees believe their contribution is consistently undervalued, misunderstandings between teams may become harder to resolve.

  Practice Managers can help by creating opportunities for employees to understand one another's responsibilities without blurring professional boundaries.

  This might involve clearer communication about workflow changes, discussion of how tasks move between teams or involving relevant colleagues when reviewing operational difficulties.

  The objective is not to make every role interchangeable. It is to ensure employees understand and respect the contribution of others.

• How can poor staff belonging affect the working environment?

  A lack of belonging may contribute to employees feeling excluded, undervalued or disconnected from the wider practice.

  These experiences can affect how people participate in team discussions, approach colleagues and respond to organisational changes.

  For example, an employee who repeatedly feels overlooked may become less willing to suggest improvements.

  A part-time colleague who regularly misses important updates may experience greater difficulty keeping informed about changes to working arrangements.

  New starters may also struggle to develop confidence if they receive technical training but little opportunity to establish relationships or understand how their role fits into the team.

  Potential signs that warrant further consideration include:

  • Employees reporting that their work is not recognised.

  • Particular teams feeling excluded from relevant decisions.

  • Inconsistent access to information or development opportunities.

  • Staff describing divisions between clinical and non-clinical colleagues.

  • New employees struggling to settle into established teams.

  • Concerns about unfair treatment or workplace relationships.

  • Employees feeling that their views carry less weight because of their position.

  These signs should not automatically be treated as evidence of a widespread cultural problem.

  For instance, an employee may feel disconnected during a period of organisational change without experiencing exclusion or unfair treatment.

  Managers should consider the circumstances and whether concerns appear repeatedly.

  It is also important not to infer how someone feels solely from their behaviour.

  An employee who prefers limited social interaction may still feel respected, included and committed to the practice.

  Belonging is about the quality of workplace inclusion, not how sociable someone appears.

• How can Practice Managers strengthen belonging across different teams?

  Practice Managers can support belonging by ensuring that employees are treated as valued contributors and have fair opportunities to participate in matters affecting their work.

  This often involves reviewing ordinary management arrangements rather than introducing a separate wellbeing programme.

  One starting point is communication.

  Employees should receive relevant information in a way that reflects their working patterns and responsibilities.

  For example, a practice that relies heavily on informal conversations between full-time colleagues may unintentionally exclude employees who work fewer days.

  Similarly, decisions affecting reception workflows should involve appropriate input from reception employees, rather than being communicated only after changes have been agreed.

  Practical approaches include:

  • Involving relevant employees when reviewing processes affecting their responsibilities.

  • Ensuring part-time and cross-site staff receive important updates.

  • Recognising contributions from clinical and non-clinical roles.

  • Providing fair access to training and development opportunities.

  • Making time for appropriate introductions and support when employees join the practice.

  • Addressing disrespectful behaviour consistently, regardless of seniority.

  • Encouraging cooperation between teams when resolving operational problems.

  Recognition does not always require a formal reward scheme.

  Employees may simply need confidence that management understands the work they undertake and considers their experience when making decisions.

  The behaviour of GP partners and senior clinical colleagues can be especially influential.

  Where senior staff communicate respectfully with all employees, they reinforce the expectation that every role deserves appropriate consideration.

  This is particularly important in practices with established professional hierarchies.

  Clinical authority and decision-making responsibilities must remain clear, but they should not prevent respectful communication or the involvement of non-clinical employees in relevant operational discussions.

• What role do fairness and inclusion play in staff belonging?

  Fair treatment and inclusion are central to helping employees feel they belong.

  Staff should have confidence that opportunities, expectations and workplace decisions are handled consistently and without unlawful discrimination.

  This is particularly relevant where employees have different working patterns, personal circumstances or support requirements.

  For example, training opportunities should not routinely favour employees who happen to work on particular days.

  Colleagues working across several sites should have appropriate access to relevant information.

  Employees who require reasonable adjustments should be supported through suitable processes rather than treated as an inconvenience.

  Acas distinguishes between equality, diversity and inclusion.

  Equality concerns fair treatment and opportunities. Diversity recognises differences within the workforce. Inclusion concerns whether employees feel valued and able to contribute.

  These principles have practical implications for general practice.

  A practice may employ a diverse workforce while still needing to review whether everyone experiences the organisation as inclusive.

  The Equality Act 2010 provides legal protections against unlawful discrimination, while employers also have relevant responsibilities concerning reasonable adjustments for disabled employees.

  These legal obligations should not be confused with optional staff engagement initiatives.

  A positive culture involves meeting applicable responsibilities and examining whether everyday arrangements support fair participation.

  Practice Managers should be cautious about assuming that employees share the same needs or preferences.

  Some colleagues may appreciate social events, while others may face caring responsibilities, accessibility barriers or different working schedules.

  Belonging should not depend on participation in activities outside contracted working hours.

• How can managers help new starters and PCN staff feel included?

  Employees joining a GP practice need more than information about their immediate duties. They also benefit from understanding how the organisation works and where they can obtain support.

  A new receptionist, for example, may learn the appointment system relatively quickly but still be uncertain about how to communicate with clinicians or escalate a difficult patient interaction.

  A newly appointed administrator may need time to understand how their work connects with other departments.

  An effective induction should therefore cover both practical responsibilities and working relationships.

  Useful arrangements might include introductions to relevant colleagues, clear escalation routes, accessible procedures and opportunities to ask questions after initial training.

  Employees working in Primary Care Network roles may face additional challenges.

  They may work across several practices, have different reporting arrangements or be less involved in the informal communication that takes place within individual surgeries.

  Managers should consider whether these colleagues understand who is responsible for operational support and how they receive relevant information.

  Where responsibilities are shared between organisations, clear communication about supervision and management arrangements is particularly important.

  Belonging should not depend on being physically present in the same building every day.

  The objective is to help employees understand where they fit, who they can approach and how their contribution supports the services being delivered.

• How can GP practices understand whether staff feel they belong?

  Practice Managers can explore belonging through employee discussions, workforce feedback and observations about how teams operate.

  The aim should be to understand employees' experiences rather than assign a definitive score to organisational culture.

  A staff survey may include questions such as:

  • I feel that my contribution to the practice is valued.

  • I am treated with respect by colleagues across different roles.

  • I feel included in decisions that affect my work.

  • I have fair opportunities to develop within my role.

  • I feel part of the wider practice team.

  These questions can provide useful insight, particularly when considered alongside other information.

  For example, positive responses about immediate colleagues but less favourable feedback about wider practice inclusion may suggest difficulties with communication between departments.

  Managers should also consider whether certain employees have fewer opportunities to contribute because of their working arrangements.

  However, analysing responses by role or demographic characteristics can create confidentiality concerns in smaller practices.

  Information should only be collected where there is a clear purpose, and results should be handled appropriately.

  Survey findings do not independently establish that discrimination, poor leadership or a wellbeing problem exists.

  They may identify areas that require closer examination.

  Where employees report specific concerns about unfair treatment, management should consider the appropriate procedures rather than relying solely on general survey findings.

• How does staff belonging relate to CQC?

  Staff belonging is relevant to aspects of CQC's assessment framework concerning organisational culture, inclusive leadership and workforce equality, diversity and inclusion.

  Under the well-led key question, CQC considers whether providers work towards an inclusive and fair culture in which diversity is valued.

  Its quality statements also address shared direction and culture, capable and inclusive leadership, and freedom to speak up.

  These areas may be relevant when employees feel excluded, undervalued or unable to contribute to decisions affecting their work.

  For example, consistent concerns that particular staff groups are overlooked may warrant consideration of how the practice communicates, involves employees and ensures fair treatment.

  However, CQC does not require a particular staff belonging survey or prescribe a score that determines whether a practice has an inclusive culture.

  Workforce feedback may contribute useful evidence, but it must be considered alongside actual management arrangements and employee experiences.

  NHS England's People Promise also identifies compassionate and inclusive working environments as an important aspiration for NHS organisations.

  It includes commitments relating to belonging, recognition, staff voice and teamwork.

  For GP practices, these principles provide a useful reference point for considering how employees experience their working environment.

  The emphasis should remain on genuine inclusion rather than collecting documentation solely for assessment purposes.

• What should a Practice Manager check?

  Practice Managers may find it useful to consider whether belonging is supported consistently across the workforce.

  Questions to review include:

  • Do clinical and non-clinical employees feel their contributions are recognised?

  • Are relevant staff involved when decisions affect their responsibilities?

  • Do part-time employees receive appropriate information and opportunities?

  • Are new starters supported to understand the organisation and establish working relationships?

  • Are PCN and cross-site employees included in relevant communications?

  • Do staff have fair access to training and development?

  • Are concerns about exclusion or disrespect addressed appropriately?

  • Do employees understand how to raise concerns about unfair treatment?

  • Are professional differences managed respectfully?

  • Does workforce feedback suggest that some employees feel disconnected from the wider practice?

  These questions can support reflection on working arrangements without creating a separate formal assessment.

• Common questions about staff belonging in general practice

  Is staff belonging the same as staff wellbeing?

  No. Belonging concerns whether employees feel accepted, valued and included within the organisation. Staff wellbeing is broader and may involve workload, working conditions, support and other aspects of employee experience. The two can influence one another.

  Can employees feel a sense of belonging without attending social events?

  Yes. Belonging is principally about workplace relationships, fair treatment, respect and inclusion. Employees should not have to participate in social activities outside work to feel valued members of the practice team.

  How can a small GP practice improve staff belonging?

  Small practices can focus on fair communication, involving employees in relevant decisions, recognising different contributions and addressing exclusion or disrespect promptly. Formal engagement programmes are not always necessary.

  Can staff belonging affect recruitment and retention?

  Employees' experience of inclusion may influence how they view their workplace and whether they wish to remain. However, retention decisions are affected by many factors, including pay, career opportunities, workload and personal circumstances.

  Does CQC assess staff belonging?

  CQC does not prescribe a separate belonging score for GP practices. However, workforce experiences may be relevant to its assessment of organisational culture, inclusive leadership, equality, diversity and inclusion, and freedom to speak up.

• A practical starting point

  Improving staff belonging requires attention to how employees experience the practice, not simply whether the organisation offers social or wellbeing activities.

  Practice Managers can begin with four practical actions:

  1. Review inclusion across roles. Consider whether clinical, reception, administrative and other employees receive appropriate recognition and opportunities to contribute.

  2. Examine communication arrangements. Identify whether part-time, new and cross-site colleagues can access the information they need.

  3. Strengthen everyday management behaviour. Encourage respectful relationships, fair treatment and constructive involvement in decisions.

  4. Listen for differences in experience. Use appropriate workforce feedback to identify where employees may feel excluded or undervalued, and consider realistic improvements.

  Belonging does not require every employee to have the same experience of work.

  A GP practice contains different professional groups, responsibilities and working arrangements. Those differences should be understood and respected.

  For Practice Managers, the aim is to create an environment where employees know their contribution matters, feel included in the wider organisation and can work effectively with colleagues in the interests of patients and the practice.