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Tuesday 25 October 2016
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Back to school

Continuing professional development in primary care is often related to GPs and nurses to aid appraisal and revalidation, but there are good reasons to foster a culture of learning and development throughout the whole practice team

With practices finding it harder than ever to recruit and retain, workforce planning is one of the major concerns facing practice management. Practices are encouraged to ‘sell’ their surgeries to attract prospective employees but marketing primary care as an appealing place to work is a challenge hindered by funding cuts and an ever increasing workload. It’s easy to assume that money is the driving incentive for attracting and retaining future employees but the right working environment is just as much of a consideration when making career decisions. A practice’s biggest asset is its workforce and being part of a motivated and enthusiastic team will be an incentive to prospective employees, and help you to recruit and retain the right type of candidate.
Promoting clinical professional development (CPD) in the workplace has long been a key strategic tool for private sector companies but is all too often only restricted to clinical staff in primary care. It is an essential tool for keeping professionals updated with relevant training, information, skills and knowledge, in order to remain competent throughout their career journey.
Non-clinical staff training is mostly limited to the necessary skills to carry out existing job roles, and satisfy Care Quality Commission (CQC) requirements. This is enough to meet our duty as an employer but are we really investing in our teams and tapping into the potential for personal growth? By introducing an CPD into the workplace, opportunities to fill workforce gaps are exploited and team performance and morale improves.
CPD is not about providing the training for the individual, it’s about encouraging them to explore learning opportunities for themselves. Giving permission for your employees to broaden their horizons with practice support, be it through protected time, potential for promotion or funding for courses, will empower staff to be self-motivated in their own career development.

Being challenged
Promoting CPD in a young, vibrant, ambitious team is relatively straightforward. Establishing a platform for CPD in a well-established practice team can sometimes feel like an uphill exercise. Appraisals with those staff members who have been in post for many years and can carry out their job role standing on their heads are the easiest. Often these are the ones we, as managers, look forward to.
Practice manager (PM): Happy in your work role?
Employee (E): Yes
PM: Any learning needs?
E: No.
PM: Future career plans?
E: To stay in the post for ever.
Great news! Or is it? Is a receptionist who is going through the motions really being challenged, and are you sure you’re making best use of the rich pool of knowledge and expertise that that they have to offer? Encourage them in the appraisal to keep a CPD diary listing all the training, reading and learning. Then take the opportunity to check their progress after a month.
Employing an apprentice is often a good way of shaking up a well-established team, especially if the responsibility for training the new staff member is delegated. The process of imparting knowledge learned from years of experience will help to boost the confidence of long-standing employees and may also encourage them to embark on learning journeys of their own. It also helps with succession planning for the future workforce.
Practice managers are well versed in discussing learning outcomes from significant events. Rather than seeing this as a tick box exercise, why not make the sharing of learning experiences a regular agenda item in staff meetings? Promoting CPD by encouraging staff members to discuss their personal learning journeys, ambitions and occupational objectives in a group setting is a good way to cultivate an awareness of the benefits of CPD and promote peer support.

Tailored training
Job-specific CPD starts by encouraging employees to recognise that they are a professional in their own right; this could be your cleaning team ensuring that they are up to date with infection control policies, or your reception team updating their customer care skills. Nurturing a supportive environment for professional development not only ensures your colleagues have the necessary proficiencies but also helps to kindle interest in advancement and upskilling.
With a clear endorsement for training the rewards are bountiful. Retaining key staff members who have a wealth of experience is always preferable but often blighted by employees’ own personal ambitions. Propelling these employees forward into new areas of interest through upskilling within the practice, saves time and money often wasted through the recruitment gamble and provides a renewed enthusiasm and symbiotic objective for both manager and employee.
Advertising new vacancies in-house, making it clear that training will be provided for the right candidate and highlighting those transferrable key skills, such as knowledge of your in-house procedures and clinical system, will help to draw interested people. In addition, the opportunity to ensure that the training is tailored to the needs of the practice can be invaluable. These individuals know the practice, have bought into the values and ethos, and will be able to build on the skills and knowledge that they already possess.
In my practice, we have a secretary who is an ex-receptionist, a health care assistant (HCA) who is an ex-paramedic, a HCA who is former admin apprentice and a care co-ordinator who used to be a senior receptionist. Our practice nurses are ex midwives and one of whom has recently trained as a senior nurse practitioner/prescriber. The staff members who have upskilled into admin, clinical and social prescribing roles have done so by realising their potential through CPD and making the most of recruiting opportunities when they arose

Plan of action
However, it should be noted that any practice that supports CPD with a view to upskilling needs to be well thought out. Dangling the carrot is not enough – a clear career pathway needs to be agreed or you may risk losing your employee to your neighbouring practices.
Financial concerns often restrict practices from promoting CPD in the workplace. However, there are an abundant of opportunities for funded courses, such as government apprenticeship funding. Working with government agencies such as the Skills Funding Agency will help practice managers source and apply for this funding. Your local medical committee may also be running courses at reduced rates and there is the option of collaborating with surgeries in your area to keep costs low. Clinical commissioning groups may also have funding for training, especially if it’s likely to have cost benefits. In addition, with the focus on collaborative working between primary and secondary care – there are more opportunities for practices to piggyback on training that is funded and organised by their local hospital trust.
Of course there is always a risk of upskilling your staff members to the advantage of the employer, when they leave for bigger and better horizons. In order to make sure that you benefit from your investment it is important to have in place a firm training and study leave protocol and that a training ‘payback’ clause is written into employee contracts. This will help to recoup the costs of training and development if your employee decides to leave before you get a chance to utilise their newfound skills and confidence. Two to three years is a reasonable amount of time for any major investment such as financing a qualification or new skill, but be careful about being discriminate and check your employment law before implementing any new contract changes across the board.
However, where staff members are looking to leave to progress their career it is worthwhile trying to find out why they feel that they cannot do so in your surgery. People are inherently resistant to change and therefore having the opportunity to progress within a familiar setting is much more favourable compared to enduring an interview and the insecurity of a new employer, colleagues and working environment. Is there the opportunity to ‘grow’ with your staff members by offering new services to your patients or by working with new health partners to maximise income for the practice?
In my experience, promoting CPD and supported learning in a practice team benefits everyone and is a win/win situation. By encouraging individual staff members to achieve their personal ambitions, be the best they can and to raise their professional game, we are able to deliver a greater quality of care and service to our patients.

Emmy Butcher, practice manager and business partner.